Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | OH |
NPI | 1225685506 |
---|---|
Provider Name | David Adams |
First Address | Maple Heights, OH 44137-9504 |
Second Address | Cleveland, OH 44113-4917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2019 |
Last Update Date | 21/08/2019 |