Doctor Name: | NINA HATTIANGADI THOMAS |
NPI Number: | 1841382983 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PS015551 |
Business Practice Address: | 3405 Civic Center Blvd Csh-021 Philadelphia, PA - 191044302 |
Business Phone Number: | 2155907555 |
Business Fax Number: | 2155907387 |
Mailing Address: | 3440 Market St, Suite 410 PHILADELPHIA |
State: | PA |
Postal Code: | 191043325 |
Phone Number: | 2155907532 |
Fax Number: | 2155904251 |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PS015551 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |