Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | PC002691 | PA |
NPI | 1255494308 |
---|---|
Provider Name | Mrs. Marie Sensenig |
First Address | Reading, PA 19610 |
Second Address | Reading, PA 19601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11556042 | CAGH ID# (01) |