Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PA005767 | PA |
NPI | 1003111097 |
---|---|
Provider Name | Mr. Eric Joel Neifert |
First Address | Pottsville, PA 17901-2030 |
Second Address | Pottsville, PA 17901-2030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2011 |
Last Update Date | 20/07/2011 |