| NPI | 1669924189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO JOSEPH BURKE President 215-805-9445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 304056) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 1375) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 1375) | |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2016-11-01 |