Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 103K00000X | Behavior Analyst |
NPI | 1003047424 |
---|---|
Provider Name | Peter Scoma |
First Address | Lebanon, PA 17046-5040 |
Second Address | Lancaster, PA 17603-3749 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2009 |
Last Update Date | 03/08/2009 |