Doctor Name: | MR. DARYUSH PARVINBENAM |
NPI Number: | 1003007147 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PCC |
License Number: | E.0004156-SUPV |
Business Practice Address: | 2233 Rocky Ln Ashland, OH - 448054701 |
Business Phone Number: | 4192813716 |
Business Fax Number: | 4192814605 |
Mailing Address: | Po Box 9189, CANTON |
State: | OH |
Postal Code: | 447119189 |
Phone Number: | 4192813716 |
Fax Number: | 4192814605 |
NPI Enumeration Date: | 08/05/2007 |
NPI Last Update Date: | 08/05/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | E.0004156-SUPV |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |