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General NPI Number Information
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NPI Number | 1306010160
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Entity Type | Organization
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Legal Business Name | OATS PC
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 625 MONTGOMERY AVE
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City | BRYN MAWR
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State | PA
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Zip | 19010-3504
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Country | US
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Telephone | 610-563-8958
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Fax | 610-687-6172
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Provider Business Mailing Address
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Address Line | 104 ANTON RD
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City | WYNNEWOOD
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State | PA
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Zip | 19096-1226
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Country | US
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Telephone | 610-687-6172
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Fax | 610-687-3385
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Authorized Official
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Title or Position | SECRETARY
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Name | MS. LINDA A MAY
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Credential | CW
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Telephone | 610-687-6172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CW014356
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License Number State | PA
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