Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 3251 | NJ |
NPI | 1215039664 |
---|---|
Provider Name | Dr. Carl Laurence Shesler |
First Address | Madison, NJ 07940-1818 |
Second Address | Madison, NJ 07940-1818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |