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NPI Code Detail

MEDICARE: DR. MARILYN MUSSOMELI PSY.D.

MEDICARE:  DR. MARILYN  MUSSOMELI  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPC000484PA

General Provider Information

NPI Number : 1629191846
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARILYN MUSSOMELI PSY.D.
Provider Business Mailing Address
First Line : 4672 VERA CRUZ RD APT A
Second Line :
City : EMMAUS
State : PA
Zip : 18049-9509
Country : US
Telephone Number : 610-965-8291
Fax Number :
Provider Business Practice Location Address
First Line : 11 SALLY ANN FURNACE RD
Second Line :
City : MERTZTOWN
State : PA
Zip : 19539-9200
Country : US
Telephone Number : 610-682-2246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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Directions to “ DR. MARILYN MUSSOMELI PSY.D.” Practice Location

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