| NPI | 1093125023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND HANSEN Licensed Professional Counselor 814-849-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: PA 001152) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: PA 001152) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2014-07-22 |