| Organization Name: | THE WELL RED LION PSYCHOLOGY,P.C. |
| NPI Number: | 1366864001 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID HAYNES-WELLER (PRESIDENT) |
| Mailing Address: | 30 E Broadway Red Lion |
| State: | PA US |
| Postal Code: | 173561402 |
| Phone Number: | 7172441082 |
| Fax Number: | 7172441064 |
| NPI Enumeration Date: | 01/15/2014 |
| NPI Last Update Date: | 10/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS017368 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |