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General NPI Number Information
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NPI Number | 1285907113
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Entity Type | Organization
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Legal Business Name | CTEC SERVICES
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 7 PARTRIDGE TRL
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City | SHIPPENSBURG
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State | PA
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Zip | 17257-9443
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Country | US
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Telephone | 717-530-5460
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Fax |
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Provider Business Mailing Address
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Address Line | 7 PARTRIDGE TRL
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City | SHIPPENSBURG
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State | PA
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Zip | 17257-9443
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Country | US
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Telephone | 717-530-5460
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | DR. ALBERT L PARRILLO III
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Credential | PHD
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Telephone | 717-658-5581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC003740
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License Number State | PA
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