Individual
MARK IMBRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
204 E HARFORD STREET, MILFORD, PA 18337
(570) 296-2145
Mailing address
PO BOX 1281, MILFORD, PA 18337
(570) 296-2145
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS006329L
PA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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