| NPI | 1821486846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Coor 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 103T00000X Psychologist | |
| 103TR0400X Psychologist, Rehabilitation | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2020-11-20 |