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General NPI Number Information
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NPI Number | 1356421580
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Entity Type | Organization
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Legal Business Name | BRYN MAWR PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 210 LONE OAK DR
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City | BRYN MAWR
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State | PA
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Zip | 19010-2049
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Country | US
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Telephone | 610-527-5152
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Fax | 610-527-5242
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Provider Business Mailing Address
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Address Line | 210 LONE OAK DR
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City | BRYN MAWR
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State | PA
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Zip | 19010-2049
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Country | US
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Telephone | 610-527-5152
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Fax | 610-527-5242
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Authorized Official
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Title or Position | OWNER
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Name | DR. NANCY R BLOOMFIELD
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Credential | PH.D.
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Telephone | 610-527-5152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PS002631L
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License Number State | PA
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