Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | TX |
NPI | 1093133480 |
---|---|
Provider Name | Samuel Ojediran |
First Address | Katy, TX 77449-7705 |
Second Address | Katy, TX 77449-7705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 02/04/2014 |