Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1184930042 |
---|---|
Provider Name | Brian E Griswold |
First Address | Cockeysville, MD 21030-3315 |
Second Address | Towson, MD 21204-5132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2010 |
Last Update Date | 29/08/2010 |