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Individual
MR. GARY LEE DIPPEL
Active
Individual
MR. GARY LEE DIPPEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1025809
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1025809
LICSW
MA
Enumeration date
12/15/2006
Last updated
07/08/2007
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