| Forensic Treatment Services | |
|
726 Church St Fogelsville PA 18051-1603 | |
| (610) 530-8392 | |
| (610) 530-8940 |
| Full Name | Forensic Treatment Services |
|---|---|
| Speciality | Psychologist |
| Location | 726 Church St, Fogelsville, Pennsylvania |
| Authorized Official Name and Position | Veronique Nicole Valliere (PRESIDENT) |
| Authorized Official Contact | 6105308392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forensic Treatment Services 726 Church St P.o. Box 864 Fogelsville PA 18051-1603 Ph: (610) 530-8392 | Forensic Treatment Services 726 Church St Fogelsville PA 18051-1603 Ph: (610) 530-8392 |
| NPI Number | 1356390165 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 11/13/2008 |
| Medicare PECOS PAC ID | 4587725767 |
|---|---|
| Medicare Enrollment ID | O20081205000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356390165 | NPI | - | NPPES |
| 01929559 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS007952L (Pennsylvania) | Primary |
| Provider Name | Veronique N Valliere |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396775177 PECOS PAC ID: 5890856074 Enrollment ID: I20081205000540 |
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