Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1134304272 |
---|---|
Provider Name | Joanna Mary Patronis |
First Address | Cramerton, NC 28032-1221 |
Second Address | Cramerton, NC 28032-1221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2008 |
Last Update Date | 08/01/2008 |