| NPI | 1376918573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LEE CEO 215-991-9066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS016044) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: PA PS016044) |
| 103TC0700X Psychologist Clinical (Licence: PA PS016044) | |
| 103TC1900X Psychologist Counseling (Licence: PA PS016044) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PA PS016044) | |
| 103TF0000X Psychologist Family (Licence: PA PS016044) | |
| 103TH0004X Psychologist Health (Licence: PA PS016044) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: PA PS016044) | |
| 103TS0200X Psychologist School (Licence: PA PS016044) | |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |