Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | PC004551 | PA |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | PC004551 | PA |
N | 101YM0800X | Mental Health Counselor | PC004551 | PA |
N | 101YP1600X | Pastoral Counselor | PC004551 | PA |
N | 101YP2500X | Professional Counselor | PC004551 | PA |
NPI | 1205092657 |
---|---|
Provider Name | Marsha G Vosburgh Austin |
First Address | Bethlehem, PA 18017 |
Second Address | Bethlehem, PA 18017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2008 |
Last Update Date | 28/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PC004551 | PROFESSIONAL LICENSE (01) | PA |