| NPI | 1679306583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREEN ANN BRENNAN HERRON Pmhnp 570-772-4633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-08-26 |