Organization
BEHAVIORAL ADVANCEMENTS OF DUBOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN P GARRED M., LPC, CRC (LICENSED PSYCHOLOGIST)
(814) 375-7090
Entity
Organization
Contact information
Practice address
105 WEST DUBOIS AVENUE, JUNIATA PLACE SUITE B, DUBOIS, PA 15801
(814) 375-7090
(814) 375-7940
Mailing address
105 WEST DUBOIS AVENUE, JUNIATA PLACE SUITE B, DUBOIS, PA 15801
(814) 375-7090
(814) 375-7940
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS007054L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017312240003
—
PA
01
—
489548
HIGHMARK BLUE CROSS
PA
01
—
VC0634
COMMUNITY CARE BEHAVIORAL
PA
Enumeration date
04/02/2008
Last updated
04/02/2008
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