Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003227562 |
---|---|
Provider Name | Robert Jarrard III |
First Address | Worcester, MA 01604-3069 |
Second Address | Worcester, MA 01604-3069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2014 |
Last Update Date | 17/05/2014 |