Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003209990 |
---|---|
Provider Name | Lori Shevitz |
First Address | Hermitage, PA 16148-2727 |
Second Address | Hermitage, PA 16148-2727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2015 |
Last Update Date | 17/03/2015 |