Individual
MRS. DIANA GROSS HAZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, MT-BC
Contact information
Practice address
25 COLLEGE ST, BOYERTOWN, PA 19512-1405
(484) 333-5164
Mailing address
25 COLLEGE ST, BOYERTOWN, PA 19512-1405
(484) 333-5164
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC016087
PA
225A00000X
Music Therapist
10546
PA
Other
Enumeration date
05/22/2016
Last updated
04/25/2024
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