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General NPI Number Information
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NPI Number | 1497001341
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Entity Type | Individual
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Provider Name | HALLIE KUSHNER PHD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 1601 WALNUT ST SUITE 706
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City | PHILADELPHIA
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State | PA
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Zip | 19102-2944
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Country | US
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Telephone | 215-839-9735
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 MARKET ST FL 30
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City | PHILADELPHIA
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State | PA
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Zip | 19107-2934
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Country | US
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Telephone | 215-503-3685
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Fax | 215-955-2420
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS017226
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License Number State | PA
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