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General NPI Number Information
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NPI Number | 1154465474
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Entity Type | Individual
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Provider Name | MARIA LIA CAPPABIANCA
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 2808 STATE ST STE 100
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City | ERIE
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State | PA
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Zip | 16508-1830
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Country | US
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Telephone | 814-981-0269
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Fax | 814-455-4146
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Provider Business Mailing Address
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Address Line | 5340 NIEMEYER RD
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City | ERIE
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State | PA
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Zip | 16509-3237
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Country | US
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Telephone | 814-440-8384
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Fax | 814-455-4146
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PC002701
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License Number State | PA
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