Provider Demographics
NPI:1447523147
Name:CONTRI, DOUGLAS EDWARD (PSYD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:EDWARD
Last Name:CONTRI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9235
Mailing Address - Country:US
Mailing Address - Phone:570-768-5633
Mailing Address - Fax:
Practice Address - Street 1:153 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9235
Practice Address - Country:US
Practice Address - Phone:570-768-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-12
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008698L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist