MEDICARE: NEA MOTZER

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
1	101YP2500X	Professional Counselor	PC005433	PA

General Provider Information

NPI Number	:	1316431984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEA MOTZER

Provider Business Mailing Address
First Line	:	2700 W 21ST ST STE 25
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16506-2972
Country	:	US
Telephone Number	:	814-602-4466
Fax Number	:	814-315-1016

Provider Business Practice Location Address
First Line	:	2700 W 21ST ST STE 25
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16506-2972
Country	:	US
Telephone Number	:	814-602-4466
Fax Number	:	814-315-1016

Authorized Official
Title or Position	:	OWNER
Name	:	NEA ELIZABETH MOTZER
Credential	:	LPC
Telephone Number	:	814-602-4466

Provider Enumeration Date	:	06/18/2018
Last Update Date	:	06/18/2018

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Directions to “NEA MOTZER ” Practice Location

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