Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1134671225 |
---|---|
Provider Name | Carolyn Heard |
First Address | La Place, LA 70068-2418 |
Second Address | La Place, LA 70068-2418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2016 |
Last Update Date | 25/10/2016 |