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General NPI Number Information
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NPI Number | 1588142251
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Entity Type | Organization
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Legal Business Name | SMOKER COUNSELING SERVICES
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Dates
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Enumeration Date | 08/03/2018
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Last Update Date | 08/03/2018
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Provider Practice Location Address
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Address Line | 19 W RIDGE RD
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City | LITITZ
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State | PA
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Zip | 17543-7843
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Country | US
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Telephone | 717-475-4153
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Fax |
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Provider Business Mailing Address
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Address Line | 19 W RIDGE RD
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City | LITITZ
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State | PA
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Zip | 17543-7843
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Country | US
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Telephone | 717-475-4153
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | JENNIFER SMOKER
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Credential |
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Telephone | 717-475-4153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | PC008183
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License Number State | PA
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