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General NPI Number Information
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NPI Number | 1497706352
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Entity Type | Individual
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Provider Name | DOLORES R MARCHESANO DSW LICENSED PSYCHOL
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Gender | Female
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 426 PENNSYLVANIA AVENUE SUITE 201
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-3410
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Country | US
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Telephone | 610-519-0113
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Fax |
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Provider Business Mailing Address
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Address Line | 219 SUGARTOWN ROAD UNIT H301
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City | WAYNE
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State | PA
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Zip | 19087-3041
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Country | US
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Telephone | 610-688-6224
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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 | PS008147L
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License Number State | PA
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