Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1063862258 |
---|---|
Provider Name | Michael Steven Moates |
First Address | Denton, TX 76210-6839 |
Second Address | Denton, TX 76210-6839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2016 |
Last Update Date | 29/03/2021 |