Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP2500X | Professional Counselor |
NPI | 1003586371 |
---|---|
Provider Name | Trevor Allen Schabert |
First Address | Mankato, MN 56001-3569 |
Second Address | Mankato, MN 56001-3569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2021 |
Last Update Date | 03/12/2021 |