Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1003363177 |
---|---|
Provider Name | Dr. William M. Carpenter III |
First Address | Cedar Hill, TX 75104-6047 |
Second Address | Waxahachie, TX 75165-5244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2016 |
Last Update Date | 12/01/2017 |