Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1205080918 |
---|---|
Provider Name | Mr. Louis Simons |
First Address | Swampscott, MA 01907-2145 |
Second Address | Swampscott, MA 01907-2145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2008 |
Last Update Date | 22/01/2013 |