| Doctor Name: | MR. JOHN P. SIDLER |
| NPI Number: | 1992877831 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS |
| License Number: | PS-006954-L |
| Business Practice Address: | 1 Kelley Dr Coal Township, PA - 178661020 |
| Business Phone Number: | 5706447890 |
| Business Fax Number: | |
| Mailing Address: | 54 Courtland Road, SHAMOKIN DAM |
| State: | PA |
| Postal Code: | 17876 |
| Phone Number: | 5707431059 |
| Fax Number: | |
| NPI Enumeration Date: | 11/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | PS-006954-L |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |