| NPI | 1124512785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL CRAIG LISS Psychologist 215-869-8195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |