Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | OH |
NPI | 1063069169 |
---|---|
Provider Name | Mr. Steven Ray Nibert JR. |
First Address | Chillicothe, OH 45601-2452 |
Second Address | Chillicothe, OH 45601-2452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2019 |
Last Update Date | 22/08/2019 |