Full Name | |
---|---|
Speciality | Psychologist |
Location | 90 Main St, Luzerne, Pennsylvania |
Authorized Official Name and Position | Mark K Sowcik (PSYCHOLOGIST/OWNER) |
Authorized Official Contact | 5707931981 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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90 Main St Luzerne PA 18709-1210 Ph: (570) 793-1981 | 90 Main St Luzerne PA 18709-1210 Ph: (570) 793-1981 |
NPI Number | 1477985752 |
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Provider Enumeration Date | 08/08/2013 |
Last Update Date | 08/08/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477985752 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PS-004971L (Pennsylvania) | Primary |