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General NPI Number Information
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NPI Number | 1467293514
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Entity Type | Individual
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Provider Name | AMY GAIL FRISINO LPC
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | PO BOX 36
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City | WAVERLY
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State | PA
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Zip | 18471-0036
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Country | US
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Telephone | 570-563-8445
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Fax |
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Provider Business Mailing Address
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Address Line | 120 MAPLE AVE
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City | CLARKS GREEN
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State | PA
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Zip | 18411-2500
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Country | US
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Telephone | 570-209-0544
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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 | PC016755
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License Number State | PA
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