| NPI | 1801160981 |
|---|---|
| Doing Business As | PSYCH ASSOC OF FCCC, MGI |
| Entity Type | Organization |
| Authorized Contact | TONYA WOODARD Credentialing/Manager 215-707-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084P2900X Psychiatry & Neurology, Pain Medicine | |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2018-06-14 |