Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 15388 | TX |
NPI | 1003069394 |
---|---|
Provider Name | William Keith Palmer |
First Address | Dallas, TX 75235-6519 |
Second Address | Dallas, TX 75235-6519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2008 |
Last Update Date | 30/10/2008 |