| NPI | 1568567444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA JOHNSON Office Manager 215-491-6143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS005921L) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2012-02-02 |