Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401012741 | MI |
NPI | 1003186339 |
---|---|
Provider Name | Dale Parsons |
First Address | North Branch, MI 48461-8935 |
Second Address | North Branch, MI 48461-8935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2012 |
Last Update Date | 03/01/2012 |