Healthcare Provider Details

I. General information

NPI: 1114134905
Provider Name (Legal Business Name): FAMILY DEVELOPMENT SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 ERFORD RD
CAMP HILL PA
17011-2304
US

IV. Provider business mailing address

56 ERFORD RD
CAMP HILL PA
17011-2304
US

V. Phone/Fax

Practice location:
  • Phone: 717-901-9280
  • Fax: 717-909-1288
Mailing address:
  • Phone: 717-901-9280
  • Fax: 717-909-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS005101L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS005101L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS005101L
License Number StatePA

VIII. Authorized Official

Name: DR. THOMAS G. BOWERS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 717-901-9280