Provider Demographics
NPI:1891961710
Name:EUNOIA FAMILY RESOURCE CENTER PA
Entity Type:Organization
Organization Name:EUNOIA FAMILY RESOURCE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMIE
Authorized Official - Middle Name:MARLIN
Authorized Official - Last Name:VETTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYDLP
Authorized Official - Phone:507-235-6070
Mailing Address - Street 1:1420 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-3619
Mailing Address - Country:US
Mailing Address - Phone:507-235-6070
Mailing Address - Fax:
Practice Address - Street 1:1420 N STATE ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-3619
Practice Address - Country:US
Practice Address - Phone:507-235-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty