Individual
PERRY HAZELTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
243 N DUKE ST, STE 1, LANCASTER, PA 17602-2779
(717) 875-8993
Mailing address
243 N DUKE ST, STE 1, LANCASTER, PA 17602-2779
(717) 875-8993
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS007197L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02153901
CAPITALBLUECROSS
PA
01
—
214037
VALUEOPTIONS
PA
01
—
250533
ALLIANCE
PA
01
—
620005401
RRMEDICARE
PA
01
—
842925
HIGHMARK
PA
Enumeration date
08/02/2006
Last updated
06/14/2016
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