| NPI | 1831132927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DAVIS VP/COO 570-320-7696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 363A00000X Physician Assistant | |
| 103T00000X Psychologist | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2017-12-04 |