Susan McCormick
Early Intervention Provider Agency in Watsontown, PA. Individual provider (NPI-1).
NPI number1124445754
StatusActive
Last updated in NPPESMar 20, 2014
Details
- NPI
- 1124445754
- Entity type
- Individual (NPI-1)
- Name
- Susan McCormick
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 20, 2014
- Last updated
- Mar 20, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | – | – | Yes |
Practice location
1875 Vincent AveWatsontown, PA 17777-8411
Phone 570-847-2241
Mailing address
1875 Vincent AveWatsontown, PA 17777-8411
Phone 570-847-2241
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