Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003240466 |
---|---|
Provider Name | Bailey Hanek |
First Address | Hollis, NH 03049-6295 |
Second Address | Worcester, MA 01604-3069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 27/08/2013 |