Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 47174 | FL |
Y | 101YP1600X | Pastoral Counselor | 1251 | FL |
NPI | 1114181179 |
---|---|
Provider Name | Dr. W H Penewit |
First Address | Hurst, TX 76053-4634 |
Second Address | Hurst, TX 76053-4634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2008 |
Last Update Date | 17/07/2008 |