Organization Name: | JEANETTE EGAN |
NPI Number: | 1487986154 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEANETTE DONNA EGAN (DIRECTOR) |
Mailing Address: | 860 Broad St Ste 106 Emmaus |
State: | PA US |
Postal Code: | 180493630 |
Phone Number: | 6109655790 |
Fax Number: | 6109655790 |
NPI Enumeration Date: | 02/05/2010 |
NPI Last Update Date: | 02/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | PC000119 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |