Organization
OAK LEAF PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE M RUSSO PSY.D. (CLINICAL PSYCHOLOGIST)
(610) 783-5000
Entity
Organization
Contact information
Practice address
1 DAVIS RD., STE. 235, VALLEY FORGE, PA 19482
(610) 783-5000
(610) 783-0525
Mailing address
1 DAVIS RD., STE. 235, PO BOX 35, VALLEY FORGE, PA 19481-0035
(610) 783-5000
(610) 783-0525
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PS015097
PA
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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