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Organization
MAIN LINE DAY, LLC
Active
Organization
MAIN LINE DAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE SILVERBERG (OFFICE MANAGER/OWNER)
(484) 584-4213
Entity
Organization
Contact information
Practice address
487 DEVON PARK DRIVE, SUITE 207, WAYNE, PA 19087
(484) 584-4213
Mailing address
487 DEVON PARK DRIVE, SUITE 207, WAYNE, PA 19087
(484) 584-4213
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
02/20/2017
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