Individual
DR. THERESA ANN HAVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
340 MONTAGE MOUNTAIN RD, MOOSIC, PA 18507-1782
(570) 346-3686
(570) 558-6838
Mailing address
340 MONTAGE MOUNTAIN RD, MOOSIC, PA 18507-1782
(570) 346-3686
(570) 558-6838
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS016798
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026969730001
—
PA
Enumeration date
10/12/2009
Last updated
02/11/2020
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