Doctor Name: | DR. STUART SHORE |
NPI Number: | 1801104476 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD, LPC |
License Number: | PC003884 |
Business Practice Address: | 418 Stump Rd Suite 203 Montgomeryville, PA - 189369645 |
Business Phone Number: | 2152643839 |
Business Fax Number: | |
Mailing Address: | 418 Stump Rd, Suite 203 MONTGOMERYVILLE |
State: | PA |
Postal Code: | 189369645 |
Phone Number: | 2152643839 |
Fax Number: | |
NPI Enumeration Date: | 09/16/2010 |
NPI Last Update Date: | 09/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC003884 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |