Provider Demographics
NPI:1528368826
Name:REPASKY, MARY (MS COUNSELING)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:REPASKY
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Gender:F
Credentials:MS COUNSELING
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:562 WYOMING AVENUE
Mailing Address - Street 2:CHOICES PROGRAM OF WYOMING VALLEY
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704
Mailing Address - Country:US
Mailing Address - Phone:570-552-3700
Mailing Address - Fax:570-552-3705
Practice Address - Street 1:562 WYOMING AVE
Practice Address - Street 2:CHOICES PROGRAM OF WYOMING VALLEY
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704
Practice Address - Country:US
Practice Address - Phone:570-552-3700
Practice Address - Fax:570-552-3705
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)