Provider Demographics
NPI:1346489226
Name:DEJONGE, DORIS E (MS)
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:E
Last Name:DEJONGE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WYNTRE BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4535
Mailing Address - Country:US
Mailing Address - Phone:717-741-4071
Mailing Address - Fax:717-741-6660
Practice Address - Street 1:8 WYNTRE BROOKE DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4535
Practice Address - Country:US
Practice Address - Phone:717-741-4071
Practice Address - Fax:717-741-6660
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005494L103TC1900X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth