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General NPI Number Information
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NPI Number | 1831599588
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Entity Type | Organization
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Legal Business Name | OAZA COUNSELING, LC
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Dates
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Enumeration Date | 09/01/2014
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Last Update Date | 09/01/2014
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Provider Practice Location Address
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Address Line | 123 W MAIN ST
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City | GIRARDVILLE
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State | PA
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Zip | 17935-1718
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Country | US
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Telephone | 570-933-5325
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Fax | 570-276-2098
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Provider Business Mailing Address
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Address Line | 123 W MAIN ST
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City | GIRARDVILLE
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State | PA
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Zip | 17935-1718
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Country | US
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Telephone | 570-933-5325
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Fax | 570-276-2098
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | SUSAN M PRUSHINSKI
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Credential | LPC
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Telephone | 570-933-5325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC006669
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License Number State | PA
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