NPI | 1417371311 |
---|---|
Entity Type | Organization |
Authorized Contact | TED S. URBAN Owner 814-864-9719 |
Organization Subpart ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2014-02-12 |
Last Update Date | 2014-02-12 |