| NPI | 1871920538 |
|---|---|
| Doing Business As | THE DOOR |
| Entity Type | Organization |
| Authorized Contact | AGNES M RAEVEN Owner 570-296-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA SW128042) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 44SC00866300) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2013-09-26 |