Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YP2500X | Professional Counselor | PC011113 | PA |
NPI | 1003370370 |
---|---|
Provider Name | Sophia Sealy Ulett |
First Address | Allentown, PA 18104-2318 |
Second Address | Allentown, PA 18101-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2019 |
Last Update Date | 06/08/2020 |