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General NPI Number Information
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NPI Number | 1700047883
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Entity Type | Organization
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Legal Business Name | MALAMUT & MOSS PC
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 950 E HAVERFORD RD STE 306B
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City | BRYN MAWR
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State | PA
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Zip | 19010-3850
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Country | US
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Telephone | 610-527-5151
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Fax | 610-527-2884
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Provider Business Mailing Address
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Address Line | 950 E HAVERFORD RD STE 306B
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City | BRYN MAWR
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State | PA
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Zip | 19010-3850
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Country | US
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Telephone | 610-527-5151
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Fax | 610-527-2884
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | BARBARA L MALAMUT
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Credential | PHD
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Telephone | 610-527-5151
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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 | PS005661L
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License Number State | PA
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