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General NPI Number Information
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NPI Number | 1518942655
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY ASSOCIATES OF BETHLEHEM, PC
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 264 E BROAD ST
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City | BETHLEHEM
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State | PA
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Zip | 18018-6224
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Country | US
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Telephone | 610-866-9311
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Fax | 610-882-2072
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Provider Business Mailing Address
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Address Line | 264 E BROAD ST
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City | BETHLEHEM
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State | PA
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Zip | 18018-6224
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Country | US
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Telephone | 610-866-9311
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Fax | 610-882-2072
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Authorized Official
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Title or Position | CEO
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Name | DR. JOANNE M REGINA
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Credential | PHD
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Telephone | 610-866-9311
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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 | PS005682L
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License Number State | PA
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