Healthcare Provider Details

I. General information

NPI: 1831100890
Provider Name (Legal Business Name): ALLISON DRU PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLISON DRU CHABOT PHD

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 EDGEWOLD LANE
MEDIA PA
19063
US

IV. Provider business mailing address

5 EDGEWOLD LN
MEDIA PA
19063-2124
US

V. Phone/Fax

Practice location:
  • Phone: 215-219-7892
  • Fax:
Mailing address:
  • Phone: 215-219-7892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS015514
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: