| NPI | 1598167553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RUSSELL Director 215-514-1170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: PA PA006981) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2015-04-10 |