Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC004335 | PA |
NPI | 1003573163 |
---|---|
Provider Name | Kimberly Stokes |
First Address | Forty Fort, PA 18704-4003 |
Second Address | Forty Fort, PA 18704-4003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2021 |
Last Update Date | 19/01/2022 |