Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1003161704 |
---|---|
Provider Name | Ms. Wenda Lois Young |
First Address | Franklinville, NJ 08322-3695 |
Second Address | Franklinville, NJ 08322-3695 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2012 |
Last Update Date | 18/07/2012 |