| NPI | 1790318988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE GROSSI Credentialing Specialist 814-868-2507 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-19 |