| NPI | 1366044885 |
|---|---|
| Doing Business As | PSYCHOLOGY ASSOC OF FCCC, MGI |
| Entity Type | Organization |
| Authorized Contact | MARY SQUADRONI Credentialing Analyst 215-707-3411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2020-11-10 |