Doctor Name: | MRS. JESSICA LEA COSBY |
NPI Number: | 1124230149 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPC RPT-S |
License Number: | PC003523 |
Business Practice Address: | 240 Liberty St Liberty Street Counseling Center Clarion, PA - 162141829 |
Business Phone Number: | 8143165491 |
Business Fax Number: | 8142265329 |
Mailing Address: | 315 Liberty Street, CLARION |
State: | PA |
Postal Code: | 162141829 |
Phone Number: | 8143165491 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 06/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC003523 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |