| NPI | 1164839312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | URSULA JOAN WANNER Director Of Corporate Operations 717-538-0161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS009042L) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |