Individual
DR. STEPHEN J LARGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
542 W 6TH ST, # 3, ERIE, PA 16507-1169
(937) 212-3845
Mailing address
542 W 6TH ST, # 3, ERIE, PA 16507-1169
(937) 212-3845
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS016742
PA
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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