Healthcare Provider Details

I. General information

NPI: 1588725949
Provider Name (Legal Business Name): DEBRA MARGULIES PLINER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 FITZWATERTOWN ROAD SUITE A-1
WILLOW GROVE PA
19090
US

IV. Provider business mailing address

630 FITZWATERTOWN ROAD SUITE A-1
WILLOW GROVE PA
19090
US

V. Phone/Fax

Practice location:
  • Phone: 215-658-4553
  • Fax: 215-658-1602
Mailing address:
  • Phone: 215-658-4553
  • Fax: 215-658-1602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS015852
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: