Provider Demographics
NPI:1922396662
Name:SIESS-TOTA, ROMY (EDD)
Entity Type:Individual
Prefix:DR
First Name:ROMY
Middle Name:
Last Name:SIESS-TOTA
Suffix:
Gender:F
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:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:LAHASKA
Mailing Address - State:PA
Mailing Address - Zip Code:18931-0536
Mailing Address - Country:US
Mailing Address - Phone:215-622-7151
Mailing Address - Fax:
Practice Address - Street 1:2772 STREET RD
Practice Address - Street 2:
Practice Address - City:LAHASKA
Practice Address - State:PA
Practice Address - Zip Code:18931-0536
Practice Address - Country:US
Practice Address - Phone:215-622-7151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005529101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional