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NPI Code Detail

MEDICARE: EXPRESSIVE CONNECTIONS LLC

MEDICARE: EXPRESSIVE CONNECTIONS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1134776164
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXPRESSIVE CONNECTIONS LLC
Provider Business Mailing Address
First Line : 2502 HIGH ST
Second Line :
City : NATRONA HEIGHTS
State : PA
Zip : 15065-2426
Country : US
Telephone Number : 724-757-4454
Fax Number :
Provider Business Practice Location Address
First Line : 2318 FREEPORT RD
Second Line :
City : NATRONA HEIGHTS
State : PA
Zip : 15065-1651
Country : US
Telephone Number : 724-757-6119
Fax Number :
Authorized Official
Title or Position : OWNER/THERAPIST
Name : JEREMY PHILLIPS
Credential :
Telephone Number : 724-757-6119
Provider Enumeration Date : 08/23/2019
Last Update Date : 08/23/2019

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Directions to “EXPRESSIVE CONNECTIONS LLC ” Practice Location

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