Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301002824 | MI |
Y | 103G00000X | Clinical Psychologist | 6301002824 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301002824 | MI |
N | 103TF0200X | Forensic Psychologist | 6301002824 | MI |
NPI | 1114957222 |
---|---|
Provider Name | Dr. Rodney Charles Howard |
First Address | Okemos, MI 48864 |
Second Address | Okemos, MI 48864 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 20/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
680C34503 | (02) | MI |