Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | PC005632 | PA |
Y | 101YP2500X | Professional Counselor | PC005632 | PA |
NPI | 1366752537 |
---|---|
Provider Name | Mrs. Lenore Edith Stine |
First Address | Bethlehem, PA 18018-6504 |
Second Address | Bethlehem, PA 18018-6504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2010 |
Last Update Date | 23/04/2015 |