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General NPI Number Information
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NPI Number | 1730423823
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Entity Type | Organization
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Legal Business Name | ALEX M. SIEGEL, J.D.,PH.D., LLC
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 915 MONTGOMERY AVE SUITE 210
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City | PENN VALLEY
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State | PA
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Zip | 19072-1548
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Country | US
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Telephone | 610-668-4240
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Fax |
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Provider Business Mailing Address
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Address Line | 915 MONTGOMERY AVE SUITE 210
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City | PENN VALLEY
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State | PA
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Zip | 19072-1548
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Country | US
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Telephone | 610-668-4240
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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. ALEX M. SIEGEL
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Credential | J.D, PH.D
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Telephone | 610-668-4240
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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 | PS-005568-L
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License Number State | PA
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