Healthcare Provider Details

I. General information

NPI: 1376966911
Provider Name (Legal Business Name): KATJA MARTHA SPRADLIN-MCHUGH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2014
Last Update Date: 12/13/2019
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W LANCASTER AVE STE 103
SHILLINGTON PA
19607-1874
US

IV. Provider business mailing address

67 MEADOW GLEN LN
READING PA
19607-9422
US

V. Phone/Fax

Practice location:
  • Phone: 610-741-6907
  • Fax:
Mailing address:
  • Phone: 646-240-7478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS017507
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS017507
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: