Doctor Name: | JAROMIR HOVAD |
NPI Number: | 1174926208 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 20 Barthel Ave Gardner, MA - 014402502 |
Business Phone Number: | 9785034782 |
Business Fax Number: | 9786303049 |
Mailing Address: | 20 Barthel Ave, GARDNER |
State: | MA |
Postal Code: | 014402502 |
Phone Number: | 9785034782 |
Fax Number: | 9786303049 |
NPI Enumeration Date: | 10/03/2014 |
NPI Last Update Date: | 10/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |