Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1215689344 |
---|---|
Provider Name | Eddie Schaaf |
First Address | Broken Bow, NE 68822-1718 |
Second Address | Broken Bow, NE 68822-1718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2022 |
Last Update Date | 20/01/2022 |