Individual
DR. PHILLIP J. TIETBOHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
232 LOGAN AVE, WYOMISSING, PA 19610-2673
(610) 741-9776
Mailing address
232 LOGAN AVE, WYOMISSING, PA 19610-2673
(610) 413-1739
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PS008196L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001847159-0006
—
PA
05
—
001847159-0007
—
PA
05
—
001847159-0008
—
PA
05
—
001847159-0009
—
PA
05
—
001847159-0012
—
PA
05
—
001847159-0013
—
PA
Enumeration date
09/20/2006
Last updated
02/03/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us