Healthcare Provider Details

I. General information

NPI: 1902228281
Provider Name (Legal Business Name): DAVID VATRAL BA, MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 STILLMEADOW LN
YORK PA
17404-1350
US

IV. Provider business mailing address

16531 SUSQUEHANNA TRL S
NEW FREEDOM PA
17349-8964
US

V. Phone/Fax

Practice location:
  • Phone: 717-683-8971
  • Fax:
Mailing address:
  • Phone: 717-683-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: