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Individual

DR. MARY B. LELWICA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
208 SKYCREST DR, LANDENBERG, PA 19350-9658
(610) 274-0641
(610) 274-0351
Mailing address
208 SKYCREST DR, LANDENBERG, PA 19350-9658
(610) 274-0641
(610) 274-0351

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS004939L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00004467874
AETNA
PA
01
0003720
COM. CARE BEHAVIORAL HEAL
PA
01
0332164000
IBC
PA
01
112680
VALUE OPTIONS
PA
01
11447341
CAQH
PA
01
206413
COMPSYCH
PA
01
61-38877
UNITED BEHAVIORAL HEALTHC
PA
01
V458L
EMPIRE
PA
Enumeration date
03/29/2007
Last updated
07/08/2007
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