Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 222790 | MA |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 222790 | MA |
N | 101YM0800X | Mental Health Counselor | 222790 | MA |
N | 101YP2500X | Professional Counselor | 222790 | MA |
N | 101YS0200X | School Counselor | 222790 | MA |
NPI | 1184211641 |
---|---|
Provider Name | Mrs. Susan R Hubler |
First Address | Brewster, MA 02631-2606 |
Second Address | Brewster, MA 02631-2606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2020 |
Last Update Date | 30/12/2020 |