Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP2500X | Professional Counselor |
NPI | 1003185562 |
---|---|
Provider Name | Mrs. Carol A. Corso |
First Address | Bethlehem, PA 18018-5518 |
Second Address | Bethlehem, PA 18018-5518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2011 |
Last Update Date | 29/12/2011 |