Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 101YP1600X | Pastoral Counselor | ST75201 | FL |
NPI | 1316599053 |
---|---|
Provider Name | Mr. Edwin S Steele |
First Address | Ocala, FL 34479-7692 |
Second Address | Ocala, FL 34479-7692 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2019 |
Last Update Date | 12/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ST75201 | LICENSED PASTORAL COUNSELOR (01) | FL |