Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | E.0004156-SUPV | OH |
NPI | 1003007147 |
---|---|
Provider Name | Mr. Daryush Parvinbenam |
First Address | Columbus, OH 43230-2732 |
Second Address | Columbus, OH 43230-2732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 23/05/2019 |