| NPI | 1710297163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY J VESLOSKI President 570-655-1667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PA PS004215L) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |