Doctor Name: | DR. MARILYN MUSSOMELI |
NPI Number: | 1629191846 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PC000484 |
Business Practice Address: | 11 Sally Ann Furnace Rd Mertztown, PA - 195399200 |
Business Phone Number: | 6106822246 |
Business Fax Number: | |
Mailing Address: | 4672 Vera Cruz Rd Apt A, EMMAUS |
State: | PA |
Postal Code: | 180499509 |
Phone Number: | 6109658291 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC000484 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |