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General NPI Number Information
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NPI Number | 1154211209
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Entity Type | Individual
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Provider Name | PRAISE IYIEWUARE PHD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 846 W LANCASTER AVE
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City | BRYN MAWR
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State | PA
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Zip | 19010-3224
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Country | US
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Telephone | 281-687-0543
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Fax |
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-218-0300
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Fax | 856-589-5082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS020454
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00803400
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License Number State | NJ
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