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General NPI Number Information
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NPI Number | 1033669601
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Entity Type | Organization
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Legal Business Name | CENTER FOR PSYCHOLOGICAL HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 10/07/2016
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 122 W LANCASTER AVE SUITE 206
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City | SHILLINGTON
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State | PA
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Zip | 19607-1881
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Country | US
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Telephone | 717-468-5308
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Fax |
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Provider Business Mailing Address
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Address Line | 122 W LANCASTER AVE SUITE 206
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City | SHILLINGTON
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State | PA
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Zip | 19607-1881
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Country | US
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Telephone | 717-468-5308
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Fax |
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Authorized Official
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Title or Position | OWNER AND PSYCHOLOGIST
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Name | DR. HEIDI M RAMSBOTTOM
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Credential | PHD
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Telephone | 717-468-5308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS017332
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License Number State | PA
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