Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003360413 |
---|---|
Provider Name | Jessica Marie Eichelberger |
First Address | Harrisburg, PA 17109-5215 |
Second Address | Harrisburg, PA 17109-5215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2016 |
Last Update Date | 15/08/2016 |