Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 4562 | MA |
NPI | 1003087263 |
---|---|
Provider Name | Paul D'espinoza |
First Address | Plymouth, MA 02362-6146 |
Second Address | Plymouth, MA 02360-4868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2008 |
Last Update Date | 17/03/2008 |