Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
N | 101YP2500X | Professional Counselor | 360 | AL |
NPI | 1194931246 |
---|---|
Provider Name | Dr. Michael Glenn Semon |
First Address | Birmingham, AL 35244 |
Second Address | Birmingham, AL 35244-2019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |