Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1144729534 |
---|---|
Provider Name | Ms. Rita Henry |
First Address | Des Moines, IA 50310-4866 |
Second Address | Windsor Heights, IA 50324-1339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2018 |
Last Update Date | 12/02/2018 |