Healthcare Provider Details
I. General information
NPI: 1467513093
Provider Name (Legal Business Name): JAMES PHILIP SCHIERBERL JR. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1357 W 6TH ST
ERIE PA
16505-2503
US
IV. Provider business mailing address
1357 W 6TH ST
ERIE PA
16505-2503
US
V. Phone/Fax
- Phone: 814-456-6078
- Fax: 814-456-6078
- Phone: 814-456-6078
- Fax: 814-456-6078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | PS004620L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: