Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1104436245 |
---|---|
Provider Name | Amanda Durgin |
First Address | Boston, MA 02135-2066 |
Second Address | Danvers, MA 01923-1924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2020 |
Last Update Date | 04/08/2020 |