Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | OH | |
Y | 101YP2500X | Professional Counselor | E7070 | OH |
NPI | 1265738686 |
---|---|
Provider Name | Mr. Thomas Howland Whiteman JR. |
First Address | Gahanna, OH 43230-5047 |
Second Address | Gahanna, OH 43230-5047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2011 |
Last Update Date | 02/02/2011 |