Provider Demographics
NPI:1447213129
Name:PABON, ANDREA (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:PABON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:PA
Mailing Address - Zip Code:18517-2215
Mailing Address - Country:US
Mailing Address - Phone:570-562-7656
Mailing Address - Fax:
Practice Address - Street 1:33 E NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-2406
Practice Address - Country:US
Practice Address - Phone:570-829-3489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)