| Doctor Name: | EUGENA PATACKAS |
| NPI Number: | 1003299397 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS LBS LPC NCC |
| License Number: | |
| Business Practice Address: | 106 Colburn Ave Clarks Summit, PA - 184111569 |
| Business Phone Number: | 5706877495 |
| Business Fax Number: | |
| Mailing Address: | 717 E Pine St, OLYPHANT |
| State: | PA |
| Postal Code: | 184471934 |
| Phone Number: | 5706877495 |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2015 |
| NPI Last Update Date: | 11/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |