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General NPI Number Information
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NPI Number | 1649435843
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Entity Type | Organization
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Legal Business Name | CROYLE-SERBIN THERAPEUTIC ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 1450 SCALP AVE SUITE 209
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City | JOHNSTOWN
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State | PA
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Zip | 15904-3374
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Country | US
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Telephone | 814-266-3196
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 SCALP AVE SUITE 209
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City | JOHNSTOWN
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State | PA
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Zip | 15904-3374
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROLE SERBIN
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Credential | LCSW
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Telephone | 814-266-3196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS003270-L
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License Number State | PA
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