Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 3181 |
NPI | 1114467834 |
---|---|
Provider Name | Dr. Louis R. Lothman |
First Address | Jacksonville, FL 32217 |
Second Address | Jacksonville, FL 32217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2017 |
Last Update Date | 28/02/2017 |