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General NPI Number Information
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NPI Number | 1871924753
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Entity Type | Organization
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Legal Business Name | RICHARD A SEKULA PHD LLC
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 2545 W 26TH ST
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City | ERIE
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State | PA
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Zip | 16506-3261
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Country | US
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Telephone | 814-397-6077
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Fax | 814-455-0997
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Provider Business Mailing Address
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Address Line | 734 GOLD AVE
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City | ERIE
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State | PA
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Zip | 16509-3059
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Country | US
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Telephone | 814-397-6077
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. RICHARD A SEKULA
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Credential | PHD
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Telephone | 814-397-6077
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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 | PS005326L
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License Number State | PA
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