Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1306022645 |
---|---|
Provider Name | Dr. Gerald Joseph Ladouceur |
First Address | Albany, NY 12208-3410 |
Second Address | Albany, NY 12208-3410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2008 |
Last Update Date | 17/01/2008 |