Doctor Name: | MR. JOHN ROBERT GASPERINI |
NPI Number: | 1043554231 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | LH00004785 |
Business Practice Address: | 20420 68th Ave W Lynnwood, WA - 980367405 |
Business Phone Number: | 4254313786 |
Business Fax Number: | |
Mailing Address: | 20420 68th Ave W, LYNNWOOD |
State: | WA |
Postal Code: | 980367405 |
Phone Number: | 4254313786 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2012 |
NPI Last Update Date: | 11/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH00004785 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |