Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 17.1-976-0-287823 | TN |
NPI | 1326708074 |
---|---|
Provider Name | Mr. Tom Danner JR. |
First Address | Steelton, PA 17113-2916 |
Second Address | Mechanicsburg, PA 17055-8417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2021 |
Last Update Date | 22/12/2021 |