Provider Demographics
NPI:1881162766
Name:NANCY J. PATRICK, PH.D. LLC
Entity type:Organization
Organization Name:NANCY J. PATRICK, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:717-497-9846
Mailing Address - Street 1:134 STIRRUP LN
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-8876
Mailing Address - Country:US
Mailing Address - Phone:717-497-9846
Mailing Address - Fax:
Practice Address - Street 1:6230 JONESTOWN RD STE A
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-6257
Practice Address - Country:US
Practice Address - Phone:717-971-2936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty