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2160 Sandy Dr Ste D State College PA 16803-2205 | |
| (814) 380-9180 | |
| (814) 406-4244 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2160 Sandy Dr Ste D, State College, Pennsylvania |
| Authorized Official Name and Position | Julie A Angstadt (OWNER & CLINICAL DIRECTOR) |
| Authorized Official Contact | 8143809180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2160 Sandy Dr Ste D State College PA 16803-2205 Ph: (814) 380-9180 | 2160 Sandy Dr Ste D State College PA 16803-2205 Ph: (814) 380-9180 |
| NPI Number | 1265032411 |
|---|---|
| Provider Enumeration Date | 10/27/2020 |
| Last Update Date | 11/14/2024 |
| Certification Date | 11/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265032411 | NPI | - | NPPES |
| 1038509600004 | Medicaid | PA | |
| 1770193708 | Other | NPI (TYPE 1) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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