| NPI | 1073968061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA ACEVEDO Executive Director 610-217-0821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05587) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |