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General NPI Number Information
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NPI Number | 1841556909
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Entity Type | Organization
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Legal Business Name | JONATHAN A. MOSELLE,PH.D. P.C
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 1244 FT WSHNGTN AVE SUITE K
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City | FT WASHINGTON
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State | PA
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Zip | 19034-1743
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Country | US
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Telephone | 215-643-2999
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Fax | 215-643-4599
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Provider Business Mailing Address
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Address Line | 1244 FT WSHNGTN AVE SUITE K
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City | FT WASHINGTON
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State | PA
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Zip | 19034-1743
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Country | US
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Telephone | 215-643-2999
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Fax | 215-643-4599
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONATHAN A. MOSELLE
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Credential | PH.D.
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Telephone | 215-643-2999
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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 | PS003458L
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License Number State | PA
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