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General NPI Number Information
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NPI Number | 1841334109
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Entity Type | Organization
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Legal Business Name | CULLEN PSYCHOLOGICAL SERVICES, PC
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 11/20/2009
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Provider Practice Location Address
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Address Line | 9331 OLD BUSTLETON AVE SUITE 101
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City | PHILADELPHIA
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State | PA
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Zip | 19115-4634
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Country | US
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Telephone | 856-228-5390
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Fax | 856-228-5390
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Provider Business Mailing Address
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Address Line | 80 BRYANT RD
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-1446
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Country | US
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Telephone | 856-228-5390
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Fax | 856-228-5390
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Authorized Official
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Title or Position | PRESIDENT, CLINICAL PSYCHOLOGIST
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Name | DR. THOMAS J CULLEN JR.
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Credential | PH.D.
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Telephone | 856-228-5390
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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 | PS002808L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS002808L
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License Number State | PA
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