Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC005879 | PA |
NPI | 1003251521 |
---|---|
Provider Name | Miss Jennifer Christine Copeland |
First Address | Erie, PA 16504-1559 |
Second Address | Erie, PA 16504-1559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2013 |
Last Update Date | 19/12/2014 |