Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1164087318 |
---|---|
Provider Name | Dr. Charles Carrington |
First Address | Virginia Beach, VA 23462-1077 |
Second Address | Virginia Beach, VA 23462-1077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2019 |
Last Update Date | 03/05/2019 |