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Individual
KEVIN C. MIYASATO
Active
Individual
KEVIN C. MIYASATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
00686
NV
1041C0700X
Clinical Social Worker
5214-S
NV
1041C0700X
Clinical Social Worker
Primary
5855
OR
Other
Enumeration date
08/02/2011
Last updated
06/06/2014
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