| Doctor Name: | KATHLEEN E SOCCIO |
| NPI Number: | 1033523576 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BSL |
| License Number: | BH001581 |
| Business Practice Address: | 1000 Commerce Park Dr 110 Williamsport, PA - 177015475 |
| Business Phone Number: | 5703236944 |
| Business Fax Number: | 5703234529 |
| Mailing Address: | 320 Highland Dr, P.o. Box 597 MOUNTVILLE |
| State: | PA |
| Postal Code: | 175541232 |
| Phone Number: | 7172857121 |
| Fax Number: | 7172850616 |
| NPI Enumeration Date: | 06/12/2014 |
| NPI Last Update Date: | 06/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | BH001581 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |