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General NPI Number Information
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NPI Number | 1255717500
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Entity Type | Organization
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Legal Business Name | SARAH PULVER PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 08/09/2015
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Last Update Date | 08/09/2015
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Provider Practice Location Address
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Address Line | 440 E GIRARD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3326
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Country | US
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Telephone | 267-574-0009
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Fax |
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Provider Business Mailing Address
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Address Line | 4626 LOCUST ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-4519
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Country | US
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Telephone | 267-574-0009
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | SARAH E PULVER
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Credential | LSW, MSW
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Telephone | 267-574-0009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | SW131112
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License Number State | PA
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