Doctor Name: | GEOFFREY D NUSBAUM |
NPI Number: | 1417978347 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | MF000283 |
Business Practice Address: | 333 N 18th Ave Ste A Pocatello, ID - 832013358 |
Business Phone Number: | 2082342660 |
Business Fax Number: | |
Mailing Address: | Po Box 4449, POCATELLO |
State: | ID |
Postal Code: | 832054449 |
Phone Number: | 2082342660 |
Fax Number: | 2082342661 |
NPI Enumeration Date: | 07/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | MF000283 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |