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Organization
COUPLES AT CROSSROADS, LLC
Active
Organization
COUPLES AT CROSSROADS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAKE D THIESSEN PHD (PRESIDENT)
(717) 433-5751
Entity
Organization
Contact information
Practice address
525 N 12TH ST, SUITE 100, LEMOYNE, PA 17043-1245
(717) 743-4223
Mailing address
525 N 12TH ST, SUITE 100, LEMOYNE, PA 17043-1245
(717) 743-4223
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF000107
PA
Other
Enumeration date
01/10/2017
Last updated
01/11/2017
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