Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003160821 |
---|---|
Provider Name | Carina Iati |
First Address | Leominster, MA 01453-3228 |
Second Address | Worcester, MA 01610-2476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2012 |
Last Update Date | 31/10/2012 |