| Omni Blue | |
|
1110 Ridge Ave # 1 Latrobe PA 15650-1926 | |
| (724) 953-1760 | |
| Not Available |
| Full Name | Omni Blue |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1110 Ridge Ave # 1, Latrobe, Pennsylvania |
| Authorized Official Name and Position | Lauralee Grace Vargo (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7249531760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Blue 1110 Ridge Ave # 1 Latrobe PA 15650-1926 Ph: (724) 953-1760 | Omni Blue 1110 Ridge Ave # 1 Latrobe PA 15650-1926 Ph: (724) 953-1760 |
| NPI Number | 1134903545 |
|---|---|
| Provider Enumeration Date | 08/24/2023 |
| Last Update Date | 08/24/2023 |
| Certification Date | 08/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134903545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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