Individual
JOHN WADE LOBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
635 MAPLE AVE, DU BOIS, PA 15801-2376
(814) 375-6379
(814) 375-9320
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6379
(814) 375-9320
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS-005831-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001655569
HIGHMARK BC/BS
PA
05
—
0019472430004
—
PA
Enumeration date
06/16/2006
Last updated
10/31/2012
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