Mary A Boutselis

NPI #1720013634 in University Park, Pennsylvania

Provider Information

NPI Number: 1720013634
Entity Type: Individual
Name: Mary A Boutselis
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Clinical
Enumeration Date: Jul 11, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 314 MOORE BUILDING
City: University Park
State: Pennsylvania
ZIP Code: 16802
Phone: (814) 865-2191

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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