Individual
DONNELLE SUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5971 TELLER RD, GIRARD, PA 16417-9112
(814) 881-5299
Mailing address
5971 TELLER RD, GIRARD, PA 16417-9112
(814) 881-5299
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
SW138765
PA
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
12/07/2015
Last updated
07/11/2024
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