Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC008035 | PA |
NPI | 1003003930 |
---|---|
Provider Name | Sean M Behan |
First Address | Willow Grove, PA 19090-1927 |
Second Address | Willow Grove, PA 19090-1927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2007 |
Last Update Date | 01/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PC008035 | STATE LICENSE (01) | PA |