| NPI | 1467096164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY WEARY Manager 814-860-3179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2022-02-15 |