Individual
TAREQ NABULSI
Active
Individual
TAREQ NABULSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT40247
CA
390200000X
Student in an Organized Health Care Education/Training Program
4087
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT40247
LICENSED PSYCHIATRIC TECHNICIAN
CA
Enumeration date
07/24/2012
Last updated
11/14/2017
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