Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health |
NPI | 1184244386 |
---|---|
Provider Name | Whitney Briana Bender |
First Address | Fort Loudon, PA 17224-9719 |
Second Address | Shippensburg, PA 17257-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2020 |
Last Update Date | 17/04/2020 |