Walles, Erica Lyn

Walles, Erica Lyn is an individual health care provider with primary practice located at 100 N Academy Ave , Danville PA 17822-1335. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Walles, Erica Lyn can be contacted via phone (570) 271-6516.

Contact Information

Primary practice address
100 N Academy Ave Danville PA 17822-1335
Fax: (570) 271-5814
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS016174 Pennsylvania

Profile Details

NPI number 1245249986
LBN Legal business name Walles, Erica Lyn
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Jan 18th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245249986 NPPES
Pennsylvania MEDICAID 1017660620001

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