Doctor Name: | MR. STANTON M DRUCKER |
NPI Number: | 1063621308 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LCS18562 |
Business Practice Address: | 101 E Alma St Suite 302 Mount Shasta, CA - 960672288 |
Business Phone Number: | 5309262542 |
Business Fax Number: | 5309263953 |
Mailing Address: | Po Box 261, MOUNT SHASTA |
State: | CA |
Postal Code: | 960670261 |
Phone Number: | 5309262542 |
Fax Number: | 5309263953 |
NPI Enumeration Date: | 05/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS18562 |
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 |