Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
Y | 101YP1600X | Pastoral Counselor | AL |
NPI | 1013361930 |
---|---|
Provider Name | Mr. Michael Anthony Cox |
First Address | Texas City, TX 77590-3880 |
Second Address | Texas City, TX 77590-3880 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2016 |
Last Update Date | 17/04/2016 |