Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1780061507 |
---|---|
Provider Name | Frank Howe |
First Address | Downey, ID 83234-0282 |
Second Address | Downey, ID 83234-0282 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 30/04/2015 |