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General NPI Number Information
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NPI Number | 1912117417
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Entity Type | Individual
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Provider Name | PENELOPE NECKOWITZ PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 544 KENNETT PIKE UNIT 2
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City | CHADDS FORD
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State | PA
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Zip | 19317-9384
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Country | US
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Telephone | 610-388-4468
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Fax |
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Provider Business Mailing Address
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Address Line | 10 ORCHARD VW
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City | CHADDS FORD
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State | PA
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Zip | 19317-9236
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Country | US
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Telephone | 610-388-2622
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS005671L
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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 | B1-0000261
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License Number State | DE
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