Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1205397619 |
---|---|
Provider Name | William Dowel Cunningham |
First Address | Asheville, NC 28803-1956 |
Second Address | Asheville, NC 28803-1956 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2019 |
Last Update Date | 28/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1760 | COUNSELING (01) | NC |