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General NPI Number Information
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NPI Number | 1871710301
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Entity Type | Individual
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Provider Name | ELIZABETH R. RICHMAN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 133 COULTER AVE SUITE 1
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City | ARDMORE
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State | PA
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Zip | 19003
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Country | US
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Telephone | 610-896-8666
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Fax | 610-896-8665
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Provider Business Mailing Address
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Address Line | 2401 PENNSYLVANIA AVE #21 C 45
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City | PHILADELPHIA
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State | PA
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Zip | 19130
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Country | US
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Telephone | 267-319-1139
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Fax | 215-247-0905
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PS003186-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS003186-L
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License Number State |
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