| NPI | 1841240371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HOLDREN CAO 570-271-5490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry | |
| 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology | |
| 101Y00000X Counselor | |
| 104100000X Social Worker | |
| 363A00000X Physician Assistant | |
| 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health | |
| 103T00000X Psychologist | |
| 103G00000X Clinical Neuropsychologist | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2008-06-27 |