Individual
MR. VALJEAN EUGENE LICON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1005 FOREST ST, RENO, NV 89509-2706
(775) 329-4582
(775) 329-9943
Mailing address
200 GOOSEBERRY DR, RENO, NV 89523-9612
(775) 240-1818
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
CP0124
NV
106H00000X
Marriage & Family Therapist
Primary
01375
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114513284
—
NV
Enumeration date
05/23/2011
Last updated
09/18/2019
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