| The Well Red Lion Psychology,p.c. | |
|
30 E Broadway Red Lion PA 17356-1402 | |
| (717) 244-1082 | |
| (717) 244-1064 |
| Full Name | The Well Red Lion Psychology,p.c. |
|---|---|
| Speciality | Psychologist |
| Location | 30 E Broadway, Red Lion, Pennsylvania |
| Authorized Official Name and Position | David Haynes-weller (PRESIDENT) |
| Authorized Official Contact | 7173413366 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Well Red Lion Psychology,p.c. 529 Crestwood Dr Red Lion PA 17356-9434 Ph: (717) 246-6431 | The Well Red Lion Psychology,p.c. 30 E Broadway Red Lion PA 17356-1402 Ph: (717) 244-1082 |
| NPI Number | 1366864001 |
|---|---|
| Provider Enumeration Date | 01/15/2014 |
| Last Update Date | 10/03/2014 |
| Medicare PECOS PAC ID | 6002036506 |
|---|---|
| Medicare Enrollment ID | O20141006000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366864001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS017368 (Pennsylvania) | Primary |
| Provider Name | David Haynes-weller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831482579 PECOS PAC ID: 5597997478 Enrollment ID: I20140408000308 |
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