Individual
MARY A BOUTSELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 MOORE BUILDING, UNIVERSITY PARK, PA 16802
(814) 865-2191
(814) 863-1331
Mailing address
314 MOORE BUILDING, UNIVERSITY PARK, PA 16802
(814) 865-2191
(814) 863-1331
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS005233L
PA
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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