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1912166158
TINA MARIE DESPORT
LATROBE, PA
NPI
1912166158
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: PA SW129788)
Enumeration Date
2008-06-03
Last Update Date
2013-04-17
Business Address
Mrs. TINA MARIE DESPORT LSW
1001 LIGONIER ST
LATROBE, PA 15650-1832
Phone number: 724-537-0760
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Mailing Address
Mrs. TINA MARIE DESPORT LSW
125 HILLSIDE RD
DERRY, PA 15627-2686
Phone number: 724-244-7784
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