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Individual

DR. JESSICA ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D, NCSP

Contact information

Practice address
1616 WALNUT ST, 2108, PHILADELPHIA, PA 19103-5313
(347) 749-0348
Mailing address
40 HARRISON ST, 21E, NEW YORK, NY 10013-2742
(347) 749-0348

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
1189167
NY
103TS0200X
School Psychologist
Primary
562042
NJ

Other

Enumeration date
05/01/2012
Last updated
05/01/2012
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