Doctor Name: | MR. GEORGE SALA |
NPI Number: | 1053624353 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LCS 11726 |
Business Practice Address: | 880 Joshua Ct Brookings, OR - 974159394 |
Business Phone Number: | 5414690918 |
Business Fax Number: | |
Mailing Address: | Po Box 5810, BROOKINGS |
State: | OR |
Postal Code: | 974150216 |
Phone Number: | 5414690918 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2010 |
NPI Last Update Date: | 07/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS 11726 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |