Individual
MRS. LYDIA B HACKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
344 N READING RD, EPHRATA, PA 17522-1651
(717) 738-1125
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS019329
PA
103TC0700X
Clinical Psychologist
PS019329
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103403833
—
PA
01
—
PS019329
STATE LICENSE
PA
Enumeration date
04/16/2016
Last updated
07/15/2024
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