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General NPI Number Information
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NPI Number | 1073951984
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Entity Type | Organization
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Legal Business Name | ELIZABETH SOUCAR, PH.D., LLC
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 696 SECOND STREET PIKE SUITE 201
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City | RICHBORO
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State | PA
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Zip | 18954-1068
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Country | US
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Telephone | 267-229-8465
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Fax |
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Provider Business Mailing Address
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Address Line | 34 HEATHER CT
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City | NEWTOWN
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State | PA
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Zip | 18940-1542
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Country | US
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Telephone | 267-229-8465
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | ELIZABETH SOUCAR
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Credential | PH.D.
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Telephone | 267-229-8465
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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 | PS016692
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License Number State | PA
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