Provider Demographics
NPI:1316021835
Name:OBRIEN, GARY LEE (LMHC CDP RN)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:LEE
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:LMHC CDP RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:319 S MERIDIAN
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-5913
Mailing Address - Country:US
Mailing Address - Phone:253-841-4284
Mailing Address - Fax:253-841-4286
Practice Address - Street 1:319 S MERIDIAN
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-5913
Practice Address - Country:US
Practice Address - Phone:253-841-4284
Practice Address - Fax:253-841-4286
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health