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Individual

MR. GEOFFREY MARTIN WYCKOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1082 TAYLORSVILLE RD, SUITE 105, WASHINGTON CROSSING, PA 18977-1305
(267) 399-9962
(267) 392-5236
Mailing address
1082 TAYLORSVILLE RD, SUITE 105, WASHINGTON CROSSING, PA 18977-1305
(267) 399-9962
(267) 392-5236

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35510065400
NJ
103T00000X
Psychologist
PS007870L
103TC2200X
Clinical Child & Adolescent Psychologist
PS007870L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001971881
HIGHMARK BLUE SHIELD
PA
01
0236042000
PERSONAL CHOICE
PA
01
092332000
MAGELLAN
PA
01
7044367
AETNA
PA
01
P1088196
OXFORD
PA
01
Q63396
AMERIHEALTH ADMINISTRATOR
PA
Enumeration date
03/07/2007
Last updated
09/20/2022
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