Organization
VISUALIZE CHANGE, LLC
Active
Parent organization
NO
Organization subpart
Yes
Provider details
NPI number
Legal business name
NO
Authorized official
LORI WETZEL MS LPC NCC CCTP (FACILITY OWNER)
(570) 875-3333
Entity
Organization
Contact information
Practice address
913 CENTRE ST, ASHLAND, PA 17921-1243
(570) 875-3333
(570) 875-3433
Mailing address
913 CENTRE ST, ASHLAND, PA 17921-1243
(570) 875-3333
(570) 875-3433
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
547030
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030502410001
—
PA
Enumeration date
05/27/2015
Last updated
05/05/2017
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