Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PS006482L | PA |
NPI | 1033226683 |
---|---|
Provider Name | Mark F. Urich |
First Address | Butler, PA 16001-2418 |
Second Address | Butler, PA 16001-2418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 28/12/2010 |