Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
Y | 1041C0700X | Clinical Social Worker | SW007093L | PA |
NPI | 1184902207 |
---|---|
Provider Name | Ms. Anne Marie Cormier |
First Address | Douglassville, PA 19518-1698 |
Second Address | Douglassville, PA 19518-1698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2011 |
Last Update Date | 22/07/2011 |