Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1184270282 |
---|---|
Provider Name | Benjamin Allen Molin |
First Address | Eugene, OR 97402-3758 |
Second Address | Eugene, OR 97401-5899 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2019 |
Last Update Date | 14/08/2019 |