Doctor Name: | BARRY R. BRINK |
NPI Number: | 1053311217 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PS008801L |
Business Practice Address: | 110 Radnor Rd Suite 101 State College, PA - 168017987 |
Business Phone Number: | 8148670670 |
Business Fax Number: | 8148677616 |
Mailing Address: | 830 Fairway Rd, STATE COLLEGE |
State: | PA |
Postal Code: | 168033412 |
Phone Number: | 8142315250 |
Fax Number: | |
NPI Enumeration Date: | 07/28/2005 |
NPI Last Update Date: | 07/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | PS008801L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |