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Individual

CRAIG R MANDEL

Active
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Individual

CRAIG R MANDEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
992284
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
013490
KAISER-COMMERCIAL NUMBER
05
95722254
CO
Enumeration date
02/27/2007
Last updated
06/23/2021
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