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General NPI Number Information
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NPI Number | 1932080736
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Entity Type | Organization
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Legal Business Name | STILL WATERS COLLECTIVE LLC
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 3201 STATE ROUTE 257 STE 4
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City | SENECA
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State | PA
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Zip | 16346-2429
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Country | US
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Telephone | 814-657-8757
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 STATE ROUTE 257 STE 4
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City | SENECA
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State | PA
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Zip | 16346-2429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | KATIE SOTTIAUX
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Credential |
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Telephone | 814-657-8757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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