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General NPI Number Information
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NPI Number | 1871130948
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Entity Type | Organization
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Legal Business Name | CENTER FOR PSYCHOLOGICAL WELLNESS AND CHANGE LLC
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Dates
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Enumeration Date | 12/07/2019
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 6081 HAMILTON BLVD STE 600
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City | ALLENTOWN
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State | PA
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Zip | 18106-9801
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Country | US
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Telephone | 610-638-6100
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Fax | 610-638-6101
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Provider Business Mailing Address
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Address Line | 6081 HAMILTON BLVD STE 600
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City | ALLENTOWN
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State | PA
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Zip | 18106-9801
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Country | US
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Telephone | 610-638-6100
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Fax | 610-638-6101
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. MARIFEL C. ESTRADA-CURRIE
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Credential | PH.D.
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Telephone | 610-638-6100
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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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