| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 212 S 1st St, Bangor, Pennsylvania |
| Authorized Official Name and Position | Abigail Oxford (OWNER) |
| Authorized Official Contact | 6102904177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 722 Bangor PA 18013-0722 Ph: (610) 290-4177 | 212 S 1st St Bangor PA 18013-2640 Ph: (610) 290-4177 |
| NPI Number | 1275094427 |
|---|---|
| Provider Enumeration Date | 03/29/2019 |
| Last Update Date | 08/08/2023 |
| Certification Date | 08/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275094427 | NPI | - | NPPES |
| PC010082 | Other | PA | THERAPIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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