Individual
DR. STEPHEN M TIMCHACK
Active
Individual
DR. STEPHEN M TIMCHACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, BCBA-D
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC002136
PA
103K00000X
Behavior Analyst
1-01-0675
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS016722
PA
103TC0700X
Clinical Psychologist
Primary
PS016722
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PS016722
PA
Other
Enumeration date
04/04/2008
Last updated
03/27/2012
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