Provider Information for 1073086757
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NATALIE EDEN LPC, LCPC
Sex: Female
NPI: 1073086757
Last Updated: 2019-01-06
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1073086757 | ||||||||||||
| Enumeration Date | 2019-01-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 12 CRESCENT PARK WARREN, PA 16365-2217 United States Phone: 847-341-8019 | Fax: | ||||||||||||
| Primary Practice Address | 315 2ND AVE STE 207 WARREN, PA 16365-2439 United States Phone: 847-341-8019 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 564 W RANDOLPH ST FL 2 | ||||||||||||
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