Individual
LARYSSA SUE LOQUASTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
727 ANN ST, STROUDSBURG, PA 18360-2016
(484) 369-4633
Mailing address
340 E WALNUT ST, NAZARETH, PA 18064-2244
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YM0800X
PRIVATE INSURANCE
PA
05
—
101YM0800X
—
PA
Enumeration date
03/02/2021
Last updated
03/02/2021
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