Doctor Name: | MRS. KELLY GEARTY |
NPI Number: | 1134508245 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW |
License Number: | SW129839 |
Business Practice Address: | 107 E Locust St Ephrata, PA - 175222717 |
Business Phone Number: | 7173945334 |
Business Fax Number: | 7177332414 |
Mailing Address: | 107 E Locust St, EPHRATA |
State: | PA |
Postal Code: | 175222717 |
Phone Number: | 7173945334 |
Fax Number: | 7177332414 |
NPI Enumeration Date: | 05/21/2015 |
NPI Last Update Date: | 05/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | SW129839 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |