Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1194394114 |
---|---|
Provider Name | Luz Luna |
First Address | Brooklyn, NY 11208-1023 |
Second Address | Brooklyn, NY 11208-1023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2021 |
Last Update Date | 23/06/2021 |