Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC003725 | PA |
N | 101YS0200X | School Counselor | PA |
NPI | 1134227010 |
---|---|
Provider Name | Prof. Barbara Blakley |
First Address | Grove City, PA 16127-1003 |
Second Address | Grove City, PA 16127-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 31/07/2007 |