Doctor Name: | CASEY LOEBS |
NPI Number: | 1396179644 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CAS |
License Number: | |
Business Practice Address: | 16611 Victory Blvd Apt 307 Lake Balboa, CA - 914065617 |
Business Phone Number: | 6268028287 |
Business Fax Number: | |
Mailing Address: | 16611 Victory Blvd, Apt 307 LAKE BALBOA |
State: | CA |
Postal Code: | 914065617 |
Phone Number: | 6268028287 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2013 |
NPI Last Update Date: | 08/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |