Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1245775196 |
---|---|
Provider Name | Emma Shows |
First Address | Santa Fe, NM 87505-5603 |
Second Address | Santa Fe, NM 87505-5603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2017 |
Last Update Date | 02/01/2017 |