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NPI Code Detail

MEDICARE: JACQUELINE P SOVA PHD

MEDICARE:   JACQUELINE P SOVA  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TB0200XCognitive & Behavioral PsychologistPS008356LPA

General Provider Information

NPI Number : 1518972058
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE P SOVA PHD
Provider Business Mailing Address
First Line : 200 N 7TH ST
Second Line :
City : LEBANON
State : PA
Zip : 17046-5040
Country : US
Telephone Number : 717-272-5464
Fax Number : 717-273-1416
Provider Business Practice Location Address
First Line : 40 PEARL ST
Second Line :
City : LANCASTER
State : PA
Zip : 17603-3231
Country : US
Telephone Number : 717-397-8081
Fax Number : 717-397-8414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 10/17/2016

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Directions to “ JACQUELINE P SOVA PHD” Practice Location

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