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General NPI Number Information
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NPI Number | 1053843417
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Entity Type | Organization
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Legal Business Name | MARRIAGE AND FAMILY RESOURCE CENTER
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 94 ROLLING HILLS DR
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City | HOLLAND
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State | PA
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Zip | 18966-2206
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Country | US
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Telephone | 215-497-0574
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Fax |
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Provider Business Mailing Address
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Address Line | 94 ROLLING HILLS DR
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City | HOLLAND
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State | PA
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Zip | 18966-2206
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Country | US
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Telephone | 215-497-0574
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KULBIR RANGI
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Credential |
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Telephone | 215-497-0574
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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 | PS003410L
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License Number State | PA
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