Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1316417298 |
---|---|
Provider Name | Sharon Gaines |
First Address | Yonkers, NY 10703-1104 |
Second Address | Yonkers, NY 10703-1104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2018 |
Last Update Date | 04/12/2018 |