Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | E0500073 | OH |
NPI | 1215071873 |
---|---|
Provider Name | Mrs. Heather M Reynolds |
First Address | Bowling Green, OH 43402-4740 |
Second Address | Bowling Green, OH 43402-4740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 24/03/2015 |