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420 Holmes St Ground Floor Bellefonte PA 16823-1401 | |
| (814) 355-6782 | |
| (814) 355-6985 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 420 Holmes St, Bellefonte, Pennsylvania |
| Authorized Official Name and Position | Carol J Waltz (ADMINISTRATOR) |
| Authorized Official Contact | 8143556782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
420 Holmes St Ground Floor Bellefonte PA 16823-1401 Ph: (814) 355-6782 | 420 Holmes St Ground Floor Bellefonte PA 16823-1401 Ph: (814) 355-6782 |
| NPI Number | 1790905875 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 11/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790905875 | NPI | - | NPPES |
| 1007296630012 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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