Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1245581966 |
---|---|
Provider Name | Mrs. Monica Sherimere Taylor |
First Address | Lithonia, GA 30058-4521 |
Second Address | Lithonia, GA 30058-4521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2012 |
Last Update Date | 20/09/2012 |