Doctor Name: | BENJAMIN PAZ |
NPI Number: | 1760745020 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | C2860 |
Business Practice Address: | 215 N G St Lakeview, OR - 976301417 |
Business Phone Number: | 5419476021 |
Business Fax Number: | 5419476020 |
Mailing Address: | 215 N G St, LAKEVIEW |
State: | OR |
Postal Code: | 976301417 |
Phone Number: | 5419476021 |
Fax Number: | 5419476020 |
NPI Enumeration Date: | 06/21/2012 |
NPI Last Update Date: | 06/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | C2860 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |