Individual
GRACEANNE FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 LARCH ST, SCRANTON, PA 18509-2802
(570) 489-5561
Mailing address
116 LARCH ST, SCRANTON, PA 18509-2802
(570) 489-5561
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
05/13/2024
Last updated
04/28/2025
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