Provider Demographics
NPI:1497163596
Name:DILLON, MARY JOYCE (MA)
Entity Type:Individual
Prefix:
First Name:MARY JOYCE
Middle Name:
Last Name:DILLON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 W STATE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1377
Mailing Address - Country:US
Mailing Address - Phone:724-981-2644
Mailing Address - Fax:724-704-7224
Practice Address - Street 1:435 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4404
Practice Address - Country:US
Practice Address - Phone:814-807-0861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006104-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist