Organization Name: | A PLACE FOR CHANGE |
NPI Number: | 1437510799 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER NICOLE RANSOM (LICENSED PROFESSIONAL COUNSELOR) |
Mailing Address: | 216 Main St Mill Hall |
State: | PA US |
Postal Code: | 177511705 |
Phone Number: | 5706602803 |
Fax Number: | |
NPI Enumeration Date: | 03/15/2016 |
NPI Last Update Date: | 03/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC008736 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |