Individual
MR. RONALD JOHN GAVLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
750 E BROAD ST, HAZLETON, PA 18201-6835
(570) 455-6385
Mailing address
750 E BROAD ST, HAZLETON, PA 18201-6835
(570) 455-6385
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS-007995-L
PA
Other
Enumeration date
07/18/2017
Last updated
07/21/2022
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