Individual
MARK THEUERKAUF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS. NCC.
Contact information
Practice address
816 POPLAR ST, ERIE, PA 16502-1250
(814) 323-1891
Mailing address
816 POPLAR ST, ERIE, PA 16502-1250
(814) 323-1891
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
292308
PA
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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