Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | ||
N | 101YP2500X | Professional Counselor |
NPI | 1205173390 |
---|---|
Provider Name | Dr. David P Cotner |
First Address | Brooklyn Park, MN 55445-2656 |
Second Address | Brooklyn Park, MN 55445-1008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2013 |
Last Update Date | 28/06/2013 |