| NPI | 1578543054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY HANS DERSTINE Managing Director 814-867-9755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YM0800X Counselor, Mental Health | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2015-04-15 |