Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1306918826 |
---|---|
Provider Name | Mrs. Patricia Ann Myers |
First Address | Souderton, PA 18964-2166 |
Second Address | Montgomeryville, PA 18936-9709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |