Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PS005123L | PA |
NPI | 1134299597 |
---|---|
Provider Name | Ardis A Featherman |
First Address | York, PA 17402-3865 |
Second Address | York, PA 17402-3865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0375302000 | MAGELLAN (01) | PA |
403859 | VALUE OPTIONS (01) | PA |
50050652 | BLUE CROSS (01) | PA |
557123 | BLUE SHIELD (01) | PA |