Doctor Name: | ALISON LORRAINE FENNELL |
NPI Number: | 1831467471 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPC |
License Number: | 37PC00426500 |
Business Practice Address: | Hc 2 Box 417 Brodheadsville, PA - 183229622 |
Business Phone Number: | 5703503463 |
Business Fax Number: | |
Mailing Address: | Hc 2 Box 417, BRODHEADSVILLE |
State: | PA |
Postal Code: | 183229622 |
Phone Number: | 5703503463 |
Fax Number: | |
NPI Enumeration Date: | 12/11/2011 |
NPI Last Update Date: | 12/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 37PC00426500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |