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NPI Code Detail

MEDICARE: THE CENTER FOR AUTISM

MEDICARE: THE CENTER FOR AUTISM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2225100000XPhysical Therapist
3103T00000XPsychologist
4235Z00000XSpeech-Language Pathologist
5101YM0800XMental Health Counselor133660PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003808106
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CENTER FOR AUTISM
Provider Business Mailing Address
First Line : 3905 FORD RD
Second Line : SUITE 6
City : PHILADELPHIA
State : PA
Zip : 19131-2824
Country : US
Telephone Number : 215-878-3400
Fax Number : 215-878-2082
Provider Business Practice Location Address
First Line : 3905 FORD RD
Second Line : SUITE 6
City : PHILADELPHIA
State : PA
Zip : 19131-2824
Country : US
Telephone Number : 215-878-3400
Fax Number : 215-878-2082
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. DAVID ST. CLAIR
Credential : MBA
Telephone Number : 215-220-2105
Provider Enumeration Date : 08/16/2005
Last Update Date : 05/19/2010

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Directions to “THE CENTER FOR AUTISM ” Practice Location

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