Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | LPC 1124 | LA |
N | 101YP1600X | Pastoral Counselor |
NPI | 1053523787 |
---|---|
Provider Name | Mr. George Reid Doster |
First Address | Madisonville, LA 70447-0640 |
Second Address | Madisonville, LA 70447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 08/07/2007 |