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General NPI Number Information
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NPI Number | 1538346622
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Entity Type | Individual
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Provider Name | GEORGE CLINTON KANDLE CLERGY: B.D. & S.T.M
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Gender | Male
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 10 OLD MILL LN
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City | KATONAH
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State | NY
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Zip | 10536-1410
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Country | US
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Telephone | 914-232-8774
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Fax | 914-232-8774
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Provider Business Mailing Address
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Address Line | 10 OLD MILL LN
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City | KATONAH
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State | NY
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Zip | 10536-1410
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Country | US
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Telephone | 914-232-8774
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Fax | 914-232-8774
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 002849
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License Number State | NY
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