Individual
ANTHONY JASON DURHAM
Active
Individual
ANTHONY JASON DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
31881
CA
1041C0700X
Clinical Social Worker
Primary
65441
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65441
LCSW
CA
Enumeration date
09/18/2009
Last updated
08/24/2020
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