Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1194065615 |
---|---|
Provider Name | Robert Anthony Rost |
First Address | Gallatin, MO 64640-8352 |
Second Address | Gallatin, MO 64640-8352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2013 |
Last Update Date | 20/02/2013 |