Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC011151 | PA |
NPI | 1003440280 |
---|---|
Provider Name | Brittany Leo |
First Address | Plum, PA 15239-2600 |
Second Address | Murrysville, PA 15668-1942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2020 |
Last Update Date | 26/02/2020 |