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General NPI Number Information
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NPI Number | 1033257290
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Entity Type | Organization
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Legal Business Name | PARAKLESEOS
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 347 3RD ST
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City | BEAVER
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State | PA
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Zip | 15009-2356
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Country | US
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Telephone | 724-775-7755
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Fax | 724-775-3124
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Provider Business Mailing Address
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Address Line | 347 3RD ST
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City | BEAVER
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State | PA
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Zip | 15009-2356
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Country | US
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Telephone | 724-775-7755
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Fax | 724-775-3124
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JAMES T FLANNICK
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Credential | PSY.D.
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Telephone | 724-775-7755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS004317L
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License Number State | PA
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