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General NPI Number Information
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NPI Number | 1689893752
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Entity Type | Individual
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Provider Name | SUSAN NELSON YOUNG L.P.C., N.C.C.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1353 W 6TH ST
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City | ERIE
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State | PA
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Zip | 16505-2503
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Country | US
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Telephone | 814-459-3272
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Fax | 814-459-3714
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Provider Business Mailing Address
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Address Line | 3118 CAUGHEY RD
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City | ERIE
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State | PA
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Zip | 16506-2158
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Country | US
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Telephone | 814-459-3272
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Fax | 814-459-3714
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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 | PC003765
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License Number State | PA
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