Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | LP1739 | ME |
NPI | 1265625586 |
---|---|
Provider Name | Dr. Carol Jones Sherman |
First Address | Bangor, ME 04401-5112 |
Second Address | Bangor, ME 04401-5112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 21/08/2007 |