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General NPI Number Information
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NPI Number | 1073168795
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Entity Type | Organization
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Legal Business Name | INSIGHT WELLNESS, LLC
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 1325 N RIVER ST STE 206
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City | PLAINS
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State | PA
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Zip | 18702-1836
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Country | US
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Telephone | 570-550-4231
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 N RIVER ST STE 206
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City | PLAINS
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State | PA
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Zip | 18702-1836
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Country | US
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Telephone | 570-550-4231
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | MS. JESSICA MARTIN
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Credential |
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Telephone | 570-550-4231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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