Organization Name: | JONATHAN A. MOSELLE,PH.D. P.C |
NPI Number: | 1841556909 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JONATHAN A. MOSELLE (PRESIDENT) |
Mailing Address: | 1244 Ft Wshngtn Ave Suite K Ft Washington |
State: | PA US |
Postal Code: | 190341743 |
Phone Number: | 2156432999 |
Fax Number: | 2156434599 |
NPI Enumeration Date: | 04/03/2012 |
NPI Last Update Date: | 04/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS003458L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |