Organization Name: | SUBURBAN PSYCHOLOGICAL SERVICES, INC. |
NPI Number: | 1699963900 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEE A. BOWERS (PSYCHOLOGIST/OWNER) |
Mailing Address: | 210 Tower Rd Villanova |
State: | PA US |
Postal Code: | 190851214 |
Phone Number: | 6105200443 |
Fax Number: | 3152851598 |
NPI Enumeration Date: | 10/11/2007 |
NPI Last Update Date: | 10/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | PS-006234-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |