| NPI | 1023552908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA DORIA ELLARD Owner, Counselor 570-650-6450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: PA PC007053) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2016-12-12 |