Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC005384 | PA |
NPI | 1003211616 |
---|---|
Provider Name | Kristen Ober |
First Address | Wilkinsburg, PA 15221-2118 |
Second Address | Wilkinsburg, PA 15221-2118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2014 |
Last Update Date | 24/10/2014 |