Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | MA |
NPI | 1164909990 |
---|---|
Provider Name | Efe Igho-Osagie Shavers |
First Address | Lexington, MA 02421-6022 |
Second Address | Lexington, MA 02421-6022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2018 |
Last Update Date | 24/07/2018 |