Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1023369139 |
---|---|
Provider Name | Eric Herman |
First Address | Kalamazoo, MI 49048-3570 |
Second Address | Kalamazoo, MI 49048-2806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2012 |
Last Update Date | 28/09/2012 |