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General NPI Number Information
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NPI Number | 1295852788
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Entity Type | Individual
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Provider Name | BERNADETTE MARIE HAYBURN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 1400 BLACKHORSE HILL RD
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City | COATESVILLE
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State | PA
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Zip | 19320-2040
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Country | US
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Telephone | 610-384-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 757 BUCK LN
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City | HAVERFORD
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State | PA
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Zip | 19041-1227
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Country | US
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Telephone | 215-512-7433
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Fax |
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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 | PS016104
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License Number State | PA
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