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Individual
PAUL THOMAS MASON
Active
Individual
PAUL THOMAS MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1455-125
WI
1041C0700X
Clinical Social Worker
2820-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39638300
—
WI
Enumeration date
04/15/2008
Last updated
04/17/2008
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