| NPI | 1114062338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANNE POFFENBERGER Officer 215-493-6610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS-007072-L) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |