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Individual
MR. T.C. N/A EVERETT JR.
Active
Individual
MR. T.C. N/A EVERETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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