Doctor Name: | MRS. JACQUELYN STRAUB |
NPI Number: | 1073876132 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | PC006407 |
Business Practice Address: | 100 Pennsylvania Ave Irwin, PA - 156423552 |
Business Phone Number: | 7248630760 |
Business Fax Number: | 7248630766 |
Mailing Address: | 100 Pennsylvania Ave, Suite #3 IRWIN |
State: | PA |
Postal Code: | 156423552 |
Phone Number: | 4126105032 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2012 |
NPI Last Update Date: | 10/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC006407 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |