Organization Name: | EN GEDI PSYCHOLOGICAL SERVICES LLC |
NPI Number: | 1295125540 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYNNE ALLISON WILLIAMS (OWNER) |
Mailing Address: | 1040 Dunkels Church Rd Kutztown |
State: | PA US |
Postal Code: | 195308816 |
Phone Number: | 6105623074 |
Fax Number: | |
NPI Enumeration Date: | 01/26/2015 |
NPI Last Update Date: | 01/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS-005083-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |