| Doctor Name: | JEFFREY DAVID MARKS |
| NPI Number: | 1508070624 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. |
| License Number: | PS 006280 L |
| Business Practice Address: | 1287 County Welfare Rd Leesport, PA - 195339197 |
| Business Phone Number: | 6102084800 |
| Business Fax Number: | |
| Mailing Address: | 3940 Locust Ln, HARRISBURG |
| State: | PA |
| Postal Code: | 171094023 |
| Phone Number: | 7175455787 |
| Fax Number: | |
| NPI Enumeration Date: | 05/09/2007 |
| 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 006280 L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |