Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC011676 | PA |
NPI | 1003467424 |
---|---|
Provider Name | Natalie Joseph |
First Address | Wexford, PA 15090-6936 |
Second Address | Pittsburgh, PA 15205-1018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2019 |
Last Update Date | 26/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PC011676 | PROFESSIONAL LICENSE (01) | PA |