Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003278094 |
---|---|
Provider Name | Erin Tyndall |
First Address | Pottstown, PA 19464-6421 |
Second Address | Pottstown, PA 19464-6421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2016 |
Last Update Date | 05/04/2017 |