Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS015387 | PA |
Y | 103T00000X | Psychologist | PS015387 | PA |
N | 103TS0200X | School Psychologist | PS015387 | PA |
NPI | 1013093996 |
---|---|
Provider Name | Dr. Mark E Bigger |
First Address | Harrisburg, PA 17104-1612 |
Second Address | Harrisburg, PA 17104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 29/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103099019 | (05) | PA |