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1255311718
SUSANNA ANGELICA LACK
MEDIA, PA
NPI
1255311718
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: PA PS008960)
Enumeration Date
2006-01-20
Last Update Date
2007-07-08
Business Address
Dr. SUSANNA ANGELICA LACK Psy.D.
211 N MONROE ST 2ND FLOOR
MEDIA, PA 19063-3019
Phone number: 610-891-9923
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Mailing Address
Dr. SUSANNA ANGELICA LACK Psy.D.
207 ENGLE DR
WALLINGFORD, PA 19086-6322
Phone number: 610-565-5885
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