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General NPI Number Information
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NPI Number | 1023445251
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Entity Type | Organization
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Legal Business Name | LIVING WORD OF GOD MINISTRIES, INC.
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 9900 ULMERTON RD 218
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City | LARGO
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State | FL
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Zip | 33771-4302
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Country | US
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Telephone | 727-515-1657
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 ULMERTON RD 218
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City | LARGO
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State | FL
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Zip | 33771-4302
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Country | US
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Telephone | 727-515-1657
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Fax |
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Authorized Official
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Title or Position | CLINICAL PASTORAL COUNSELOR
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Name | DR. DOLORES T. RILEY
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Credential | PH.D.
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Telephone | 727-515-1657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 7349105 AC
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License Number State | FL
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