Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | NY |
NPI | 1043795883 |
---|---|
Provider Name | Dr. Sean A Souels |
First Address | Newark, NJ 07114-1301 |
Second Address | Newark, NJ 07114-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2018 |
Last Update Date | 27/09/2018 |