Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC006839 | PA |
NPI | 1003158445 |
---|---|
Provider Name | Sara Beth Czuchnicki |
First Address | Harrisburg, PA 17111-3872 |
Second Address | Hummelstown, PA 17036-9791 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2013 |
Last Update Date | 17/03/2018 |