Provider Demographics
NPI:1043534316
Name:HTOO, EH MOO
Entity Type:Individual
Prefix:
First Name:EH
Middle Name:MOO
Last Name:HTOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 SUMMER ST
Mailing Address - Street 2:APT 1
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:447 SUMMER ST
Practice Address - Street 2:APT 1
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905
Practice Address - Country:US
Practice Address - Phone:857-312-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health