Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 6654 | NC |
Y | 101YP2500X | Professional Counselor | 6654 | NC |
NPI | 1194916288 |
---|---|
Provider Name | Mr. Gerald W Lankford JR. |
First Address | Raleigh, NC 27606-3379 |
Second Address | Raleigh, NC 27606-3379 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 21/11/2011 |