Doctor Name: | DR. JACQUELINE PANELLAS |
NPI Number: | 1033456413 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D., ICADC |
License Number: | PY5153 |
Business Practice Address: | 145 N 6th St Reading, PA - 196013096 |
Business Phone Number: | 6102084717 |
Business Fax Number: | |
Mailing Address: | 145 N 6th St, READING |
State: | PA |
Postal Code: | 196013096 |
Phone Number: | 6102084717 |
Fax Number: | |
NPI Enumeration Date: | 01/06/2013 |
NPI Last Update Date: | 01/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY5153 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |