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Individual
ROBERTO MIGUEL MAGALLANEZ
Active
Individual
ROBERTO MIGUEL MAGALLANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
34007166A
IN
1041C0700X
Clinical Social Worker
Primary
34007166A
IN
1041C0700X
Clinical Social Worker
5074
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300062432
—
IN
Enumeration date
09/08/2011
Last updated
10/17/2022
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