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General NPI Number Information
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NPI Number | 1881787638
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Entity Type | Organization
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Legal Business Name | PHOENIXVILLE PSYCHOLOGICAL ASSOCIATES
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1220 VALLEY FORGE ROAD UNIT #38
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City | VALLEY FORGE
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State | PA
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Zip | 19482
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Country | US
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Telephone | 610-935-7077
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Fax | 610-917-9888
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Provider Business Mailing Address
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Address Line | PO BOX 911 1220 VALLEY FORGE ROAD UNIT #38
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City | VALLEY FORGE
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State | PA
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Zip | 19482
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Country | US
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Telephone | 610-935-7077
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Fax | 610-917-9888
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARY SANDRA SHEMONSKY
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Credential |
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Telephone | 610-935-7077
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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 | PS003338-L
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License Number State | PA
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