Healthcare Provider Details

I. General information

NPI: 1922347590
Provider Name (Legal Business Name): DEBRA HRICIK COLE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2013
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 MILL ST STE 102
DANVILLE PA
17821-1078
US

IV. Provider business mailing address

1116 MILL ST STE 102
DANVILLE PA
17821-1078
US

V. Phone/Fax

Practice location:
  • Phone: 570-490-0075
  • Fax: 570-271-1995
Mailing address:
  • Phone: 570-490-0075
  • Fax: 570-271-1995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS005986L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS005986L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS005986L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: