Organization Name: | DYNAMICS PSYCHOLOGICAL SERVICES, LLC |
NPI Number: | 1124475116 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL THOMAS MOSKO (OWNER) |
Mailing Address: | 1496 Cedar Top Rd Shillington |
State: | PA US |
Postal Code: | 196079324 |
Phone Number: | 6104136889 |
Fax Number: | 6103728548 |
NPI Enumeration Date: | 05/19/2016 |
NPI Last Update Date: | 05/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS016152 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |