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Individual

DAVID GLENN RISING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ED.D

Contact information

Practice address
1205 RIVER AVE FL 2, WILLIAMSPORT, PA 17701-3724
(570) 326-4118
(570) 326-5533
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS007680L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1034368990001
PA
01
6E5001
MEDICARE
PA
Enumeration date
01/25/2006
Last updated
12/05/2023
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