Individual
MISS REBECCA VICTORIA VANDEUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
131 MARKET STREET, JOHNSTOWN, PA 15901
(814) 534-0745
Mailing address
131 MARKET STREET, JOHNSTOWN, PA 15901
(814) 534-0745
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
251601146
PA
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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