Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
Y | 101YP2500X | Professional Counselor | PC005722 | PA |
N | 101YS0200X | School Counselor |
NPI | 1164728440 |
---|---|
Provider Name | Ms. Donna Marie Liu |
First Address | Media, PA 19063-1967 |
Second Address | Media, PA 19063-3527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2011 |
Last Update Date | 02/02/2011 |