Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1154979482 |
---|---|
Provider Name | Cynthia D Holcomb |
First Address | Tampa, FL 33647-4048 |
Second Address | Tampa, FL 33647-4048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2019 |
Last Update Date | 29/08/2019 |