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Individual

DODY STAR SIEGFRIED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MAPC

Contact information

Practice address
51 MARKET ST, BANGOR, PA 18013-1901
(610) 588-9109
Mailing address
2650 NORTHWOOD AVE., EASTON, PENNSYLVANIA 18045
(610) 250-0752

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
Primary

Other

Enumeration date
09/16/2013
Last updated
09/16/2013
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