Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1023297942 |
---|---|
Provider Name | Dr. William Barnes JR. |
First Address | Saint Petersburg, FL 33712-3605 |
Second Address | Saint Petersburg, FL 33712-3605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2007 |
Last Update Date | 26/10/2007 |