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General NPI Number Information
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NPI Number | 1215424650
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Entity Type | Organization
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Legal Business Name | HEART WORK & PLAY, LLC
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 50 MOUNT ZION RD
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City | YORK
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State | PA
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Zip | 17402-2635
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Country | US
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Telephone | 717-379-2284
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Fax |
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Provider Business Mailing Address
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Address Line | 129 CHURCH ST
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City | GLEN ROCK
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State | PA
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Zip | 17327-1103
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Country | US
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Telephone | 717-379-2284
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Fax |
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Authorized Official
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Title or Position | OWNER/SOLE MEMBER-CLINICIAN
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Name | DR. DEBRA A DOUBRAVA
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Credential | PHD LPC
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Telephone | 717-379-2284
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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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