Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PS002353L | PA |
NPI | 1003817834 |
---|---|
Provider Name | Dr. Peter J. Behrens |
First Address | Bethlehem, PA 18017-5115 |
Second Address | Bethlehem, PA 18018-6505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 14/03/2016 |