| NPI | 1942648043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE ANN SPRAGUE Owner 814-602-9096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC 2010-00175) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2016-08-29 |