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General NPI Number Information
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NPI Number | 1700545506
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Entity Type | Individual
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Provider Name | CARLA DEEM M.A.
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Gender | Female
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 1225 S MAIN ST STE 207
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City | GREENSBURG
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State | PA
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Zip | 15601-5370
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Country | US
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Telephone | 724-217-8847
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Fax |
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Provider Business Mailing Address
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Address Line | 309 N 5TH ST APT 4
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City | YOUNGWOOD
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State | PA
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Zip | 15697-1349
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Country | US
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Telephone | 813-361-4290
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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