Doctor Name: | THERESA M SOUZA |
NPI Number: | 1063781615 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, M.S,, T.L.L.P. |
License Number: | |
Business Practice Address: | 871 Baltimore Pike Unit 31 Glen Mills, PA - 19342 |
Business Phone Number: | 6106446464 |
Business Fax Number: | 6108890732 |
Mailing Address: | 1440 Russell Rd, PAOLI |
State: | PA |
Postal Code: | 193011236 |
Phone Number: | 6106446464 |
Fax Number: | 6108890732 |
NPI Enumeration Date: | 12/27/2011 |
NPI Last Update Date: | 12/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |