Doctor Name: | DR. MARCIE WEINER PORTMAN |
NPI Number: | 1164665014 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PS004978-L |
Business Practice Address: | 1062 Lancaster Ave. Suite 2 Rosemont, PA - 19010 |
Business Phone Number: | 6105257527 |
Business Fax Number: | 6105253997 |
Mailing Address: | 1062 Lancaster Ave., Suite 2 ROSEMONT |
State: | PA |
Postal Code: | 19010 |
Phone Number: | 6105257527 |
Fax Number: | 6105253997 |
NPI Enumeration Date: | 04/08/2009 |
NPI Last Update Date: | 04/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS004978-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |