Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0004X | Health Psychologist | PS017170 | PA |
NPI | 1851646475 |
---|---|
Provider Name | Dr. Donald Roderick Marks |
First Address | Yardley, PA 19067-1839 |
Second Address | Wilmington, DE 19805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2012 |
Last Update Date | 19/07/2012 |