Healthcare Provider Details

I. General information

NPI: 1215973615
Provider Name (Legal Business Name): JOSEPH BRIAN LACOMBE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GERMANTOWN PIKE
LAFAYETTE HILL PA
19444
US

IV. Provider business mailing address

202 HANCOCK AVE
NORRISTOWN PA
19401
US

V. Phone/Fax

Practice location:
  • Phone: 610-828-4507
  • Fax: 610-941-5532
Mailing address:
  • Phone: 610-277-3352
  • Fax: 610-941-5532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS005288L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: