Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 0734 | FL |
NPI | 1174170997 |
---|---|
Provider Name | Vivian Bell |
First Address | Clearwater, FL 33763-2319 |
Second Address | Clearwater, FL 33763-2319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2019 |
Last Update Date | 26/08/2019 |