Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1174121214 |
---|---|
Provider Name | Andrew Clark Oswalt |
First Address | Columbus, OH 43214-4119 |
Second Address | Columbus, OH 43214-4119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2020 |
Last Update Date | 12/10/2020 |