| NPI | 1124181953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE RICHARDS Supervisor Or Client Billing 814-616-0509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-09-29 |