Organization Name: | AVIS BEHAVIORAL HEALTH |
NPI Number: | 1932112174 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICIA ANN DERSHEM (PRESIDENT OWNER PSYCHOTHERAPIST) |
Mailing Address: | 302 West Central Ave. Avis |
State: | PA US |
Postal Code: | 177211070 |
Phone Number: | 5707533620 |
Fax Number: | 5707533620 |
NPI Enumeration Date: | 08/15/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CW008439L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |