| NPI | 1780393876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELINE IVETTE MAYSONET SCAVO Clinical Psychologist 570-939-2282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2022-11-17 |