Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 0059 | NC |
NPI | 1306817242 |
---|---|
Provider Name | Dr. John Arey JR. |
First Address | Charlotte, NC 28270-3806 |
Second Address | Charlotte, NC 28204-2472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 21/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
136CE | BLUE CROSS/BLUE SHIELD (01) | NC |