MEDICARE: DR. DONALD L. MCCLUNE JR. 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
1	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1942644745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD L. MCCLUNE JR. PHD

Provider Business Mailing Address
First Line	:	228 DEEPWOOD DRIVE
Second Line	:
City	:	PINE GROVE MILLS
State	:	PA
Zip	:	16868-0273
Country	:	US
Telephone Number	:	814-234-9667
Fax Number	:

Provider Business Practice Location Address
First Line	:	228 DEEPWOOD DRIVE
Second Line	:
City	:	PINE GROVE MILLS
State	:	PA
Zip	:	16868-0273
Country	:	US
Telephone Number	:	814-234-9667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	04/23/2013

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