Individual
ALICE LINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2437 W 26TH ST, ERIE, PA 16506-3220
(814) 455-0754
(814) 746-3994
Mailing address
18278 TECHNOLOGY DR, MEADVILLE, PA 16335-8380
(814) 332-0095
(814) 746-3994
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC011456
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC011456
LICENSED TYPE: PROFESSIONAL COUNSELOR
PA
Enumeration date
06/06/2019
Last updated
06/06/2019
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