Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 6524 | MA |
NPI | 1053405761 |
---|---|
Provider Name | Dr. Carol A Wintermyer |
First Address | Boston, MA 02215 |
Second Address | Boston, MA 02215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |