Doctor Name: | DR. PAUL LENTFER PANCNER |
NPI Number: | 1265542856 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 39000197A |
Business Practice Address: | 2805 Fairfield Ave Fort Wayne, IN - 468071218 |
Business Phone Number: | 2604564880 |
Business Fax Number: | 2604563559 |
Mailing Address: | 2805 Fairfield Ave, FORT WAYNE |
State: | IN |
Postal Code: | 468071218 |
Phone Number: | 2604564880 |
Fax Number: | 2604563559 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 39000197A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |