Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1104391192 |
---|---|
Provider Name | Michael Gisser |
First Address | Chapel Hill, NC 27516-4569 |
Second Address | Cary, NC 27511-4597 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2018 |
Last Update Date | 05/06/2019 |