Individual
MRS. MARION RUTH HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1176 GRANT ST, SUITE 2220, INDIANA, PA 15701-2870
(724) 349-4494
Mailing address
127 S 2ND ST, INDIANA, PA 15701-2114
(724) 349-4494
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC00219
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC002619
LICENSED PROFEFSSIONAL COUNSELOR
PA
Enumeration date
05/14/2008
Last updated
05/14/2008
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