Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YM0800X | Mental Health Counselor | PCPC004854 | PA |
NPI | 1003062571 |
---|---|
Provider Name | Jennifer Hess |
First Address | Delmont, PA 15626-1313 |
Second Address | Uniontown, PA 15401-8402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2008 |
Last Update Date | 14/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PCPC004854 | STATE LICENSE (01) | PA |