| NPI | 1568274371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLY SNYDER Lpc 570-543-2503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |