Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | IN | |
N | 101YM0800X | Mental Health Counselor | C-0005971 | OH |
N | 101YP1600X | Pastoral Counselor | 39001308A | IN |
N | 101YP1600X | Pastoral Counselor | C-0005971 | OH |
N | 101YP2500X | Professional Counselor | C-0005971 | OH |
NPI | 1215040696 |
---|---|
Provider Name | Mrs. Shawn Rene' Pogue |
First Address | Seymour, IN 47274-2991 |
Second Address | Seymour, IN 47274-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 09/07/2007 |