Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1316362932 |
---|---|
Provider Name | Keith Lohman |
First Address | Kalamazoo, MI 49004-1529 |
Second Address | Kalamazoo, MI 49004-9601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2014 |
Last Update Date | 19/02/2014 |