| En Gedi Psychological Services Llc | |
|
1040 Dunkels Church Rd Kutztown PA 19530-8816 | |
| (610) 562-3074 | |
| Not Available |
| Full Name | En Gedi Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1040 Dunkels Church Rd, Kutztown, Pennsylvania |
| Authorized Official Name and Position | Lynne Allison Williams (OWNER) |
| Authorized Official Contact | 6105623074 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| En Gedi Psychological Services Llc 1040 Dunkels Church Rd Kutztown PA 19530-8816 Ph: (610) 562-3074 | En Gedi Psychological Services Llc 1040 Dunkels Church Rd Kutztown PA 19530-8816 Ph: (610) 562-3074 |
| NPI Number | 1295125540 |
|---|---|
| Provider Enumeration Date | 01/26/2015 |
| Last Update Date | 01/26/2015 |
| Medicare PECOS PAC ID | 8527385038 |
|---|---|
| Medicare Enrollment ID | O20150323000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295125540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS-005083-L (Pennsylvania) | Primary |
| Provider Name | Lynne A Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619297181 PECOS PAC ID: 4880830413 Enrollment ID: I20130426000067 |
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