Healthcare Provider Details

I. General information

NPI: 1801012976
Provider Name (Legal Business Name): GUENTER PETER SCHRECK PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 W LANCASTER AVE SUITE 215
DEVON PA
19333-1592
US

IV. Provider business mailing address

45 CABOT DR
CHESTERBROOK PA
19087-5619
US

V. Phone/Fax

Practice location:
  • Phone: 610-995-2800
  • Fax:
Mailing address:
  • Phone: 610-296-3319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF000164
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: