Provider Demographics
NPI:1982027603
Name:OLDENBURG PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:OLDENBURG PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-832-9096
Mailing Address - Street 1:225 HUMPHREY RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4571
Mailing Address - Country:US
Mailing Address - Phone:724-832-9096
Mailing Address - Fax:724-832-2249
Practice Address - Street 1:225 HUMPHREY RD
Practice Address - Street 2:SUITE 4
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4571
Practice Address - Country:US
Practice Address - Phone:724-832-9096
Practice Address - Fax:724-832-2249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009312L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty