Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS007486L | PA |
Y | 103T00000X | Psychologist | PS007486L | PA |
NPI | 1003052473 |
---|---|
Provider Name | Michael Forrest Skarlinski |
First Address | Erie, PA 16510-2410 |
Second Address | Erie, PA 16510-2207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2009 |
Last Update Date | 29/07/2013 |