Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | PC006114 | PA |
N | 103K00000X | Behavior Analyst | 1-13-14975 |
NPI | 1003215815 |
---|---|
Provider Name | Erin Blache |
First Address | Pittsburgh, PA 15227-1117 |
Second Address | Pittsburgh, PA 15227-1117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2014 |
Last Update Date | 18/08/2014 |