Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1346820065 |
---|---|
Provider Name | Mr. John R. Muniz |
First Address | Jersey City, NJ 07307-3744 |
Second Address | Jersey City, NJ 07307-3744 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2021 |
Last Update Date | 10/05/2021 |