Healthcare Provider Details
I. General information
NPI: 1750719928
Provider Name (Legal Business Name): MEGHAN RICHETTI PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/24/2013
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
414 PAOLI PIKE
MALVERN PA
19355-3311
US
IV. Provider business mailing address
414 PAOLI PIKE
MALVERN PA
19355-3311
US
V. Phone/Fax
- Phone: 484-596-5430
- Fax: 610-296-3788
- Phone: 484-596-5430
- Fax: 610-296-3788
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PS017469 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: