Provider Demographics
NPI:1336289545
Name:PSYCHOLOGICAL ASSO OF PA PC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL ASSO OF PA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERINOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-755-0921
Mailing Address - Street 1:2647 CARNEGIE RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-3786
Mailing Address - Country:US
Mailing Address - Phone:717-755-0921
Mailing Address - Fax:717-751-0783
Practice Address - Street 1:2647 CARNEGIE RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3786
Practice Address - Country:US
Practice Address - Phone:717-755-0921
Practice Address - Fax:717-751-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty