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General NPI Number Information
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NPI Number | 1720362908
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Entity Type | Organization
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Legal Business Name | ASF PSYCHOLOGICAL AND THERPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 27 E FRONT ST
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City | MEDIA
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State | PA
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Zip | 19063-2911
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Country | US
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Telephone | 610-574-1262
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Fax |
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Provider Business Mailing Address
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Address Line | 331 W STATE ST
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City | MEDIA
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State | PA
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Zip | 19063-2615
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Country | US
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Telephone | 610-574-1262
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | AMANDA FUHRMAN
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Credential | PSYD
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Telephone | 610-574-1262
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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 | PS016287
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License Number State | PA
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