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General NPI Number Information
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NPI Number | 1235738360
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Entity Type | Organization
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Legal Business Name | HALLIE M. KUSHNER, PH.D. P.C.
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 1601 WALNUT ST STE 706
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2904
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Country | US
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Telephone | 215-839-9735
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 SPRUCE ST APT 203
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City | PHILADELPHIA
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State | PA
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Zip | 19107-6726
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Country | US
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Telephone | 773-308-5636
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HALLIE M KUSHNER
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Credential | PH.D.
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Telephone | 215-839-9735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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