Provider No. 001031930
Provider No. Service Area(s) (Region, Catchment Area or Waiver Contract Area) Region 11 1.14 Service Codes 17, 17C, 17D
Provider No. Service Area(s) (Region, Catchment Area or Waiver Contract Area) Region 06
Provider No. H H s 0 a a a a 4 6 0 a 0 9 2 a 0 1 0 2 9 4 4 2 WCA 5 SA, 7, 8, 9, 10C, 10CFC, 10COH, 11A, 11X, 13A, 13B, 13C,13D, 15, 16, 16A, 168, 18A, 20CFC, 34. 35, 36, 37. 41,418, 418A, 41E,43A,46,47,48,53,53A,54,58,61 ?EU
Provider No. Record the vocational counselor/job modification consultant’s provider number.
