Healthcare Provider Details

I. General information

NPI: 1043454911
Provider Name (Legal Business Name): RINA VENTURA MASCHLER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6122 RIDGE AVE
PHILADELPHIA PA
19128-1603
US

IV. Provider business mailing address

435 GLEN ECHO RD
PHILA PA
19119-2915
US

V. Phone/Fax

Practice location:
  • Phone: 215-487-1330
  • Fax:
Mailing address:
  • Phone: 215-266-1129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS008256L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: