Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 39003312A | IN |
N | 101YP1600X | Pastoral Counselor |
NPI | 1275942179 |
---|---|
Provider Name | Johanna Voss |
First Address | Muncie, IN 47304-2264 |
Second Address | Muncie, IN 47304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2014 |
Last Update Date | 15/08/2018 |