Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1083126593 |
---|---|
Provider Name | Dean Christopher Kavouras |
First Address | Cleveland, OH 44134-3003 |
Second Address | Cleveland, OH 44134-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2017 |
Last Update Date | 25/10/2017 |