Organization Name: | SOUTHAMPTON PSYCHIATRIC ASSOCIATES PC |
NPI Number: | 1013926583 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DENISE BEARD (OFFICE MANAGER) |
Mailing Address: | 1111 Street Rd Suite 312 Southampton |
State: | PA US |
Postal Code: | 189664250 |
Phone Number: | 2153552011 |
Fax Number: | 2153961886 |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 10/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |