Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC004638 | PA |
NPI | 1003190760 |
---|---|
Provider Name | Mr. John William Morrison JR. |
First Address | Altoona, PA 16601 |
Second Address | Huntingdon, PA 16652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2011 |
Last Update Date | 29/09/2011 |