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Individual
MR. MARK BOERTJE
Active
Individual
MR. MARK BOERTJE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.S, NCSP
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CC1003049
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC1003049
OHIO DEPARTMENT OF EDUCATION
OH
Enumeration date
12/01/2014
Last updated
12/01/2014
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