Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor |
NPI | 1023397270 |
---|---|
Provider Name | Dr. King Allen Counts |
First Address | Clarksville, TN 37042-7663 |
Second Address | Clarksville, TN 37042-7663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2011 |
Last Update Date | 20/11/2011 |