Doctor Name: | MR. MARK SAMIR SAWAF |
NPI Number: | 1053531525 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPCC |
License Number: | 0693 |
Business Practice Address: | 2415 W Highway 72 Ste 101 Harlan, KY - 408317077 |
Business Phone Number: | 6062735359 |
Business Fax Number: | 6065738321 |
Mailing Address: | 2415 W Highway 72, Ste 101 HARLAN |
State: | KY |
Postal Code: | 408317077 |
Phone Number: | 6062735359 |
Fax Number: | 6065738321 |
NPI Enumeration Date: | 04/26/2007 |
NPI Last Update Date: | 02/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0693 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |