Individual
EMILY MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Mailing address
1115 S WILTON ST, PHILADELPHIA, PA 19143-4239
(908) 391-2801
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS018244
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS018244
PA STATE LICENSE NUMBER
PA
Enumeration date
04/05/2017
Last updated
04/05/2017
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