Doctor Name: | MR. SEBASTIAAN ZUIDWEG |
NPI Number: | 1295172187 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 6287 |
Business Practice Address: | 710 N Taylor St Gunnison, CO - 812302244 |
Business Phone Number: | 9706410229 |
Business Fax Number: | 9706412949 |
Mailing Address: | Po Box 1208, MONTROSE |
State: | CO |
Postal Code: | 814021208 |
Phone Number: | 9702523200 |
Fax Number: | 9702523208 |
NPI Enumeration Date: | 05/31/2013 |
NPI Last Update Date: | 05/31/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6287 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |