Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 23200377 | PA |
NPI | 1316269509 |
---|---|
Provider Name | Dr. Debra L Sutton |
First Address | Media, PA 19063-2936 |
Second Address | Media, PA 19063-2936 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2010 |
Last Update Date | 16/02/2010 |