Healthcare Provider Details

I. General information

NPI: 1497797070
Provider Name (Legal Business Name): ASSOCIATES IN NEUROPSYCHOLOGY & COLLABORATIVE HEALTHCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 WASHINGTON BLVD
WILLIAMSPORT PA
17701-5426
US

IV. Provider business mailing address

1521 WASHINGTON BLVD
WILLIAMSPORT PA
17701-5426
US

V. Phone/Fax

Practice location:
  • Phone: 570-322-6484
  • Fax: 570-322-6788
Mailing address:
  • Phone: 570-322-6484
  • Fax: 570-322-6788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIE B SEILER
Title or Position: CLINICAL DIRECTOR
Credential: PSY.D.
Phone: 570-322-6484