Individual
JESSE THOMAS GARDINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, MS, LCPC
Contact information
Practice address
975 ROBERTA LN, SPARKS, NV 89431-6812
(775) 525-1616
Mailing address
PO BOX 2743, CARSON CITY, NV 89702-2743
(702) 768-1443
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CI5170
NV
101YP2500X
Professional Counselor
CI5170
NV
101YP2500X
Professional Counselor
Primary
CP5870
NV
Other
Enumeration date
08/24/2022
Last updated
11/18/2024
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