Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 101YP1600X | NC |
NPI | 1053666263 |
---|---|
Provider Name | Carolyn Rae Craft |
First Address | Durham, NC 27707-5444 |
Second Address | Durham, NC 27707-5444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2012 |
Last Update Date | 13/07/2012 |