Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 45 | NH |
NPI | 1184630253 |
---|---|
Provider Name | Dr. David Laural Sundell |
First Address | Salem, NH 03079-1868 |
Second Address | Nashua, NH 03063-3205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30006446 | (05) | NH |