Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS000167L | PA |
Y | 103T00000X | Psychologist | PS000167L | PA |
NPI | 1013052877 |
---|---|
Provider Name | Barry Belt |
First Address | Yardley, PA 19067-5512 |
Second Address | Yardley, PA 19067-5512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12705 | NATIONAL REGISTRY (01) | PA |