Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | CW014867 | PA |
Y | 103T00000X | Psychologist | CW014867 | PA |
NPI | 1003970146 |
---|---|
Provider Name | Mrs. Claire Donch |
First Address | Erie, PA 16502 |
Second Address | Erie, PA 16502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 08/07/2007 |