Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor |
NPI | 1275086829 |
---|---|
Provider Name | Margret Willimas |
First Address | Havana, FL 32333-5041 |
Second Address | Havana, FL 32333-5041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2016 |
Last Update Date | 01/08/2016 |