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General NPI Number Information
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NPI Number | 1962607010
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Entity Type | Individual
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Provider Name | NICOLE DANIELLA CHAIKIN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 1171 LANCASTER AVE STE 100
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City | BERWYN
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State | PA
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Zip | 19312-2602
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Country | US
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Telephone | 484-674-6324
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Fax | 484-674-6324
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Provider Business Mailing Address
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Address Line | 35 SANDY LN
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City | MALVERN
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State | PA
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Zip | 19355-3027
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Country | US
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Telephone | 610-651-0557
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Fax | 610-651-0392
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS015647
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License Number State | PA
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