Provider Demographics
NPI:1558648394
Name:RITA, CONNIE D (MA)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:D
Last Name:RITA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 HOUSTON RUN DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:GAP
Mailing Address - State:PA
Mailing Address - Zip Code:17527-9489
Mailing Address - Country:US
Mailing Address - Phone:717-442-9577
Mailing Address - Fax:
Practice Address - Street 1:835 HOUSTON RUN DR
Practice Address - Street 2:SUITE 230
Practice Address - City:GAP
Practice Address - State:PA
Practice Address - Zip Code:17527-9489
Practice Address - Country:US
Practice Address - Phone:717-442-9577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional