Healthcare Provider Details

I. General information

NPI: 1215136619
Provider Name (Legal Business Name): RACHEL MAIA GUIDES PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N WAYNE AVE SUITE 300
WAYNE PA
19087-3542
US

IV. Provider business mailing address

121 N WAYNE AVE SUITE 300
WAYNE PA
19087-3542
US

V. Phone/Fax

Practice location:
  • Phone: 610-975-9435
  • Fax:
Mailing address:
  • Phone: 610-975-9435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS-015906
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: