Individual
RONALD DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1706 GOLDEN MILE ROAD, WYSOX, PA 18854-7708
(570) 212-1482
Mailing address
1706 GOLDEN MILE RD, TOWANDA, PA 18848-9733
(570) 212-1482
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
PA
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
PA
Enumeration date
10/29/2020
Last updated
10/29/2020
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