Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003007410 |
---|---|
Provider Name | Adrienne Underkoffler |
First Address | Sellersville, PA 18960 |
Second Address | Sellersville, PA 18960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2007 |
Last Update Date | 17/09/2009 |