Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor |
NPI | 1235347451 |
---|---|
Provider Name | Dr. Walter John Warneck, Jr. |
First Address | Hilton Head Island, SC 29926-5209 |
Second Address | Hilton Head Island, SC 29928-9329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2007 |
Last Update Date | 08/07/2007 |