| NPI | 1114372026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONNIE A WAGNERWOOMER Owner 814-643-1114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 317013) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA 317013) |
| 1041C0700X Social Worker, Clinical (Licence: PA 317013) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |