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General NPI Number Information
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NPI Number | 1831501535
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Entity Type | Organization
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Legal Business Name | WENDY L. CRAYOSKY,LLC
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 518 MULBERRY ST SUITE 100
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City | HOLLIDAYSBURG
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State | PA
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Zip | 16648-1837
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Country | US
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Telephone | 814-693-6500
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Fax | 814-693-6500
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Provider Business Mailing Address
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Address Line | 6350 NICHOLAS DR
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City | HUNTINGDON
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State | PA
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Zip | 16652-8500
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Country | US
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Telephone | 814-693-6500
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Fax | 814-693-6500
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Authorized Official
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Title or Position | OWNER
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Name | MRS. WENDY LANE CRAYOSKY
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Credential | L.C.S.W.
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Telephone | 814-693-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | CW013601
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License Number State | PA
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