Doctor Name: | DR. JURIS G. DRAGUNS |
NPI Number: | 1053340968 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | PS-002378-L |
Business Practice Address: | 407 Sylvan Dr State College, PA - 168031515 |
Business Phone Number: | 8142381504 |
Business Fax Number: | 8148637002 |
Mailing Address: | 407 Sylvan Dr, STATE COLLEGE |
State: | PA |
Postal Code: | 168031515 |
Phone Number: | 8142381504 |
Fax Number: | 8148637002 |
NPI Enumeration Date: | 07/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS-002378-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |