| NPI | 1699248955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET FERRARIE Credentialing Manager 215-707-2433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-01-09 |