Individual
CHARLES ALAN BABCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
301 GROFF AVE, ELIZABETHTOWN, PA 17022-2820
(717) 575-7444
(717) 948-6108
Mailing address
P.O. BOX 486, ELIZABETHTOWN, PA 17022-0486
(717) 575-7444
(717) 948-6108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS 007207L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS 007207L
LICENSE PSYCHOLOGY
PA
Enumeration date
02/07/2011
Last updated
02/21/2012
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