Provider Demographics
NPI:1649430703
Name:DAY, JONATHAN R (PSYD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:R
Last Name:DAY
Suffix:
Gender:M
Credentials:PSYD
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 346
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-0346
Mailing Address - Country:US
Mailing Address - Phone:570-366-3739
Mailing Address - Fax:570-366-3708
Practice Address - Street 1:1260 CENTRE TPKE STE 105
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-8956
Practice Address - Country:US
Practice Address - Phone:570-366-3739
Practice Address - Fax:570-366-3708
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016269103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist