Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 72707 | TX |
NPI | 1003225889 |
---|---|
Provider Name | Mr. Jaron Hataway |
First Address | Frisco, TX 75033 |
Second Address | Frisco, TX 75033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2014 |
Last Update Date | 06/08/2014 |