Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS016127 | PA |
Y | 103TC0700X | Clinical Psychologist | PS016127 | PA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PS016127 | PA |
NPI | 1043328974 |
---|---|
Provider Name | Dr. Janine S York |
First Address | Birdsboro, PA 19508-9178 |
Second Address | Birdsboro, PA 19508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 16/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1990454 | BLUE SHIELD (01) | PA |
9737329 | AETNA (01) | PA |