| NPI | 1629615810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENDY LYNN VIEL GANIM Psychologist 610-350-6092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2020-01-17 |