Organization
LOTUS THERAPEUTIC & EMPOWERMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN MARIE DECKER LCSW (LICENSED CLINICAL SOCIAL WORKER)
(570) 878-7757
Entity
Organization
Contact information
Practice address
502 CHURCH ST, MOOSIC, PA 18507-1602
(570) 878-7757
Mailing address
502 CHURCH ST, MOOSIC, PA 18507-1602
(570) 878-7757
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030643090001
—
PA
Enumeration date
07/18/2019
Last updated
07/18/2019
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