Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1023310273 |
---|---|
Provider Name | Dr. Paul Copeland |
First Address | Fort Pierce, FL 34951-2343 |
Second Address | Fort Pierce, FL 34951-2343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2010 |
Last Update Date | 20/11/2010 |