Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | PC005367 | PA |
N | 101YP1600X | Pastoral Counselor | PC005367 | PA |
Y | 101YP2500X | Professional Counselor | PC005367 | PA |
NPI | 1164747135 |
---|---|
Provider Name | Mrs. Emma Jane Celeste |
First Address | Beaver, PA 15009-2420 |
Second Address | Beaver, PA 15009-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2010 |
Last Update Date | 02/04/2010 |