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710 Frable Road Broadheadsville PA 18322 | |
(570) 764-4706 | |
(570) 402-2056 |
Full Name | |
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Speciality | Social Worker |
Location | 710 Frable Road, Broadheadsville, Pennsylvania |
Authorized Official Name and Position | Ellyn Kravette (PRESIDENT/CLINICIAN) |
Authorized Official Contact | 5707644706 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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710 Frable Road Broadheadsville PA 18322 Ph: (570) 764-4706 | 710 Frable Road Broadheadsville PA 18322 Ph: (570) 764-4706 |
NPI Number | 1861589079 |
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Provider Enumeration Date | 10/07/2006 |
Last Update Date | 03/04/2014 |
Identifier | Type | State | Issuer |
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1861589079 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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104100000X | Social Worker | SW012506L (Pennsylvania) | Primary |