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General NPI Number Information
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NPI Number | 1295707305
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Entity Type | Individual
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Provider Name | LINDA ANN PETTI PHD
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Gender | Female
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 1250 GREENWOOD AVE SUITE 4
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City | JENKINTOWN
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State | PA
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Zip | 19046-2901
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Country | US
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Telephone | 215-885-2990
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Fax | 215-885-2366
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Provider Business Mailing Address
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Address Line | 1250 GREENWOOD AVE SUITE 4
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City | JENKINTOWN
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State | PA
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Zip | 19046-2901
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Country | US
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Telephone | 215-885-2990
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Fax | 215-885-2366
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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 | PS003471L
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License Number State | PA
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