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Individual

MR. JEFFREY DIETZ HYSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSW

Contact information

Practice address
218 BRIDGE AVE, SUNBURY, PA 17801-1006
(570) 286-4982
(570) 286-4984
Mailing address
218 BRIDGE AVE, SUNBURY, PA 17801-1006
(570) 286-4982

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
125596
PA

Other

Enumeration date
05/02/2011
Last updated
05/02/2011
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