Individual
LISA K ROONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
191 PRESIDENTIAL BLVD, SUITE 113, BALA CYNWYD, PA 19004-1215
(610) 812-6163
Mailing address
315 VALLEY RD, MERION STATION, PA 19066-1519
(610) 812-6163
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS005188L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0483287000
PERSONAL CHOICE
PA
01
—
3282980
AETNA
PA
01
—
568609000
MIS
PA
01
—
RO651955
BLUE SHIELD
PA
Enumeration date
07/15/2006
Last updated
08/24/2016
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