Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 105090 | MA |
NPI | 1205319084 |
---|---|
Provider Name | Peter B Meyer |
First Address | Milford, MA 01757-2060 |
Second Address | Milford, MA 01757-2060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2018 |
Last Update Date | 08/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105090 | LICSW (01) | MA |