Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor |
NPI | 1053754291 |
---|---|
Provider Name | George A Vanarnam |
First Address | Cazenovia, NY 13035-1028 |
Second Address | Cazenovia, NY 13035-1406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 08/04/2013 |