Individual
MR. IVAN D KAUFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, MMT
Contact information
Practice address
7435 LA BOLSA DR, DALLAS, TX 75248-4248
(214) 359-6072
(214) 359-6072
Mailing address
7435 LA BOLSA DR, DALLAS, TX 75248-4248
(214) 359-6072
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
26064
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1590812-01
—
TX
Enumeration date
07/03/2006
Last updated
07/09/2007
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