Individual
ADID MANUEL ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
(413) 732-7419
Mailing address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/30/2012
Last updated
12/13/2012
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