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Individual

DAVID MICHAEL PASTUCKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
16 S CENTRE ST, POTTSVILLE, PA 17901-3001
(570) 628-5234
(570) 682-9051
Mailing address
505 S WYLAM ST, FRACKVILLE, PA 17931-2424
(570) 874-0333

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS005313L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1446230
PA
Enumeration date
03/17/2009
Last updated
03/17/2009
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