| Doctor Name: | SAM MASON |
| NPI Number: | 1003230723 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 101YP1600X |
| Business Practice Address: | 310 N Hospital Dr Paola, KS - 660711304 |
| Business Phone Number: | 9132949175 |
| Business Fax Number: | 9132949175 |
| Mailing Address: | 310 N Hospital Dr, PAOLA |
| State: | KS |
| Postal Code: | 660711304 |
| Phone Number: | 9132949175 |
| Fax Number: | 9132949175 |
| NPI Enumeration Date: | 02/17/2014 |
| NPI Last Update Date: | 02/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | 101YP1600X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |