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General NPI Number Information
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NPI Number | 1619519204
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Entity Type | Organization
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Legal Business Name | MAXWELL PSYCHOLOGICAL SERVICES, INC.
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 2121 W MAGNOLIA BLVD
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City | BURBANK
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State | CA
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Zip | 91506-1706
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Country | US
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Telephone | 818-841-8215
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 W MAGNOLIA BLVD
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City | BURBANK
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State | CA
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Zip | 91506-1706
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Country | US
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Telephone | 818-841-8215
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. PAMELA J. MAXWELL
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Credential | PH.D.
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Telephone | 818-841-8215
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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 |
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License Number State |
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