Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1144741802 |
---|---|
Provider Name | Mr. David Heard JR. |
First Address | Baltimore, MD 21229-1407 |
Second Address | Baltimore, MD 21229-1407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2017 |
Last Update Date | 03/07/2017 |