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General NPI Number Information
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NPI Number | 1326368374
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Entity Type | Organization
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Legal Business Name | RALPH E. LANDEFELD PH.D. P.C.
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 06/01/2010
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Provider Practice Location Address
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Address Line | 15957 CONNEAUT LAKE RD. SUITE 7
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City | MEADVILLE
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State | PA
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Zip | 16335
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Country | US
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Telephone | 814-336-5387
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Fax | 814-807-1416
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Provider Business Mailing Address
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Address Line | 10159 NANCY DRIVE
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City | MEADVILLE
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State | PA
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Zip | 16335
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Country | US
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Telephone | 814-336-5387
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Fax | 814-817-1416
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. RALPH EDWIN LANDEFELD
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Credential | PH.D.
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Telephone | 724-601-4901
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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 | PS002990L
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License Number State | PA
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