| NPI | 1518346451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANON BERRY Psychotherapist 570-763-9443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ 37PC00503200) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: PA PC006772) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |