Healthcare Provider Details

I. General information

NPI: 1265253058
Provider Name (Legal Business Name): RESONANCE THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 RUBANDO DR
SPRING BROOK TOWNSHIP PA
18444-6430
US

IV. Provider business mailing address

28 RUBANDO DR
SPRING BROOK TOWNSHIP PA
18444-6430
US

V. Phone/Fax

Practice location:
  • Phone: 570-676-6700
  • Fax:
Mailing address:
  • Phone: 570-676-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JENNIFER JULSTEDT
Title or Position: OWNER
Credential: LPC
Phone: 570-676-6700