Healthcare Provider Details

I. General information

NPI: 1104886548
Provider Name (Legal Business Name): PROFESSIONAL DEVELOPMENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PFOUTS ST
HANOVER TOWNSHIP PA
18706-3116
US

IV. Provider business mailing address

5 PFOUTS ST
HANOVER TOWNSHIP PA
18706-3116
US

V. Phone/Fax

Practice location:
  • Phone: 570-829-0795
  • Fax:
Mailing address:
  • Phone: 570-829-0795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS MORRIS
Title or Position: OWNER
Credential:
Phone: 570-829-0795