Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1154683662 |
---|---|
Provider Name | Mrs. Prunella Mary Davidson |
First Address | Reading, PA 19601-3543 |
Second Address | Reading, PA 19601-3543 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 11/06/2012 |