| NPI | 1861938730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ELLIS Psychologist/Manager 484-838-5855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS016670) |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2017-01-16 |