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General NPI Number Information
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NPI Number | 1144326331
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Entity Type | Individual
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Provider Name | JEFFREY SCOTT VANLONE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 434 MARKET ST STE 204A
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City | LEWISBURG
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State | PA
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Zip | 17837-1493
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Country | US
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Telephone | 475-434-0941
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Fax |
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Provider Business Mailing Address
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Address Line | 635 ASHURST RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-5625
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Country | US
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Telephone | 215-380-0745
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PS015616
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License Number State | PA
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