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General NPI Number Information
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NPI Number | 1215855440
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Entity Type | Individual
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Provider Name | CARLEE ROSETTA SHOWAN
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Gender | Female
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 200 BEN AVE
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City | MILL HALL
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State | PA
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Zip | 17751-1214
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Country | US
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Telephone | 570-893-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 51 EISENHOWER CROSS RD
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City | MILL HALL
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State | PA
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Zip | 17751-9320
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Country | US
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Telephone |
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH008565
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License Number State | PA
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