Provider Demographics
NPI:1275619777
Name:WYKOFF, DONALD HAROLD (EDD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:HAROLD
Last Name:WYKOFF
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 SLIPPERY ROCK RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127
Mailing Address - Country:US
Mailing Address - Phone:724-458-7907
Mailing Address - Fax:724-458-7907
Practice Address - Street 1:1049 SLIPPERY ROCK RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127
Practice Address - Country:US
Practice Address - Phone:724-458-7907
Practice Address - Fax:724-458-7907
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS0015976103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist