Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
Y | 101YP2500X | Professional Counselor | 71354 | TX |
NPI | 1063774354 |
---|---|
Provider Name | Henshaw D Mbosowo |
First Address | Plano, TX 75025-3455 |
Second Address | Mckinney, TX 75070-6556 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 24/04/2019 |