Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | ||
N | 101YP2500X | Professional Counselor | 1366 | SC |
NPI | 1174119275 |
---|---|
Provider Name | Rodney Steven Kerr |
First Address | Salisbury, NC 28146 |
Second Address | Spartanburg, SC 29306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2020 |
Last Update Date | 14/12/2020 |