Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003124520 |
---|---|
Provider Name | Eneida Qirko |
First Address | Holden, MA 01520-1474 |
Second Address | Holden, MA 01520-1474 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2010 |
Last Update Date | 06/12/2021 |