Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | ||
Y | 101YP2500X | Professional Counselor | PC009946 | PA |
NPI | 1003579210 |
---|---|
Provider Name | Hannah June Allis |
First Address | Towanda, PA 18848 |
Second Address | Towanda, PA 18848-9342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2021 |
Last Update Date | 15/10/2021 |