Provider Demographics
NPI:1922434455
Name:DAHL, RONALD J (PHD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:DAHL
Suffix:
Gender:M
Credentials:PHD
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 92
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17551-0092
Mailing Address - Country:US
Mailing Address - Phone:717-872-0568
Mailing Address - Fax:717-872-8134
Practice Address - Street 1:932 NATIONAL HWY STE 4
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7380
Practice Address - Country:US
Practice Address - Phone:717-808-8400
Practice Address - Fax:717-781-2078
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017397103TF0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
1649675992OtherGROUP NPI