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General NPI Number Information
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NPI Number | 1366152894
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Entity Type | Individual
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Provider Name | LAURESA ANN GULVAS LPC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2022
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 240 ALLEGHENY BLVD STE H
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City | BROOKVILLE
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State | PA
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Zip | 15825-2326
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Country | US
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Telephone | 814-849-2488
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Fax |
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Provider Business Mailing Address
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Address Line | 101 COLLEGE ST
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City | EMLENTON
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State | PA
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Zip | 16373-9711
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Country | US
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Telephone | 814-590-3394
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC015110
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License Number State | PA
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