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General NPI Number Information
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NPI Number | 1750990263
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Entity Type | Organization
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Legal Business Name | PATTEY FONG PSYCHOLOGY ASSOCIATES
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 1062 E LANCASTER AVE STE 25
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City | BRYN MAWR
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State | PA
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Zip | 19010-1567
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Country | US
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Telephone | 610-526-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 1062 E LANCASTER AVE STE 25
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City | BRYN MAWR
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State | PA
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Zip | 19010-1567
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Country | US
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Telephone | 610-526-1900
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. PATTEY LEEANNE FONG
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Credential | PH.D.
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Telephone | 610-526-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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