Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003112707 |
---|---|
Provider Name | Kadey Soren |
First Address | Allentown, PA 18104-4354 |
Second Address | Allentown, PA 18102-2802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2011 |
Last Update Date | 28/01/2011 |