Individual
BRENDA DAUGHERTY-SHRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 PINNACLE DR, CLARION, PA 16214-3800
(814) 223-9914
(814) 223-9917
Mailing address
100 SHENANGO AVE, SHARON, PA 16146-1503
(814) 223-9914
(814) 223-9917
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC000561
PA
101YP2500X
Professional Counselor
Primary
PC000561
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC000561
LICENSED PROFESSIONAL COUNSELOR
PA
Enumeration date
01/13/2010
Last updated
11/02/2023
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