Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 12051 | CA |
NPI | 1336359629 |
---|---|
Provider Name | Dr. Martha Holland Thorson |
First Address | Hemet, CA 92545-5332 |
Second Address | Redlands, CA 92373-5243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 03/08/2011 |