Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1083888440 |
---|---|
Provider Name | Stanley C Nate |
First Address | Rock Springs, WY 82901-6244 |
Second Address | Rock Springs, WY 82901-6244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 01/05/2008 |