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Organization

BEHAVIORAL WELLNESS GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHILLIP JOHN PRALL JR. MS, CRC, LPC (LICENSED PROFESSIONAL COUNSELOR)
(570) 780-6558
Entity
Organization

Contact information

Practice address
1819 MAIN ST # A, BLAKELY, PA 18447-1351
(570) 780-6558
Mailing address
1819 MAIN ST # A, BLAKELY, PA 18447-1351
(570) 780-6558

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
11/07/2023
Last updated
11/07/2023
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