Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
Y | 101YP2500X | Professional Counselor |
NPI | 1144859356 |
---|---|
Provider Name | Dr. Mancy Howard JR. |
First Address | Youngtown, AZ 85363-1163 |
Second Address | Youngtown, AZ 85363-1163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2020 |
Last Update Date | 08/04/2020 |