Healthcare Provider Details

I. General information

NPI: 1154050664
Provider Name (Legal Business Name): ALICIA PLYLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 W 23RD ST STE 1
ERIE PA
16506-5803
US

IV. Provider business mailing address

4950 W 23RD ST STE 1
ERIE PA
16506-5803
US

V. Phone/Fax

Practice location:
  • Phone: 814-459-2755
  • Fax: 814-456-4873
Mailing address:
  • Phone: 814-459-2755
  • Fax: 814-456-4873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC012452
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: