Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1255643805 |
---|---|
Provider Name | Dr. Timothy D Vasser |
First Address | Arlington Heights, IL 60004-1112 |
Second Address | Arlington Heights, IL 60004-1112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2010 |
Last Update Date | 12/07/2010 |