Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | E 0002801 SUPV | OH |
NPI | 1003004409 |
---|---|
Provider Name | Mr. Walter Andrew Bartashus |
First Address | Wooster, OH 44691-7904 |
Second Address | Wooster, OH 44691-7904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2007 |
Last Update Date | 10/10/2007 |