Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1114264546 |
---|---|
Provider Name | Miss Ronnette Elizabeth Martin |
First Address | Harrisburg, PA 17105-5402 |
Second Address | Harrisburg, PA 17110-1876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2013 |
Last Update Date | 04/01/2013 |