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General NPI Number Information
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NPI Number | 1972931806
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Entity Type | Individual
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Provider Name | JOHN JOSEPH GUERIN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2013
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Last Update Date | 11/01/2013
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Provider Practice Location Address
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Address Line | 426 PENNSYLVANIA AVE SUITE 115
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-3410
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Country | US
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Telephone | 215-628-8800
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Fax | 215-699-1554
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Provider Business Mailing Address
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Address Line | 426 PENNSYLVANIA AVE SUITE 115
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-3410
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Country | US
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Telephone | 215-628-8800
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Fax | 215-699-1554
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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 | PS-004341-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | SI-00003704
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License Number State | NJ
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