NPI | 1790165553 |
---|---|
Entity Type | Organization |
Authorized Contact | JOAN M CICCHIELLO Executive Director 570-875-8058 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP009838) |
Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: PA TP006931C) |
Enumeration Date | 2015-06-05 |
Last Update Date | 2015-06-05 |