Healthcare Provider Details

I. General information

NPI: 1639812415
Provider Name (Legal Business Name): DD THERAPY SOURCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 BETHLEHEM PIKE STE 3301
ERDENHEIM PA
19038-8111
US

IV. Provider business mailing address

717 BETHLEHEM PIKE STE 3301
ERDENHEIM PA
19038-8111
US

V. Phone/Fax

Practice location:
  • Phone: 215-341-1020
  • Fax:
Mailing address:
  • Phone: 215-341-1020
  • Fax: 267-766-6514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE DARDEN
Title or Position: CLINICAL COUNSELOR
Credential: LPC
Phone: 215-341-1020