Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | BCPC0614 | VA |
NPI | 1174942478 |
---|---|
Provider Name | Sherrie Anderson |
First Address | Moss Point, MS 39562-8625 |
Second Address | Moss Point, MS 39562-8625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 15/04/2014 |