Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1208154 | SC |
N | 101YP1600X | Pastoral Counselor | LJGBC2404 | WV |
NPI | 1013330513 |
---|---|
Provider Name | Mr. Ray Hoskins |
First Address | Columbia, SC 29209-3218 |
Second Address | Columbia, SC 29203-6818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2014 |
Last Update Date | 04/02/2014 |