Individual
GERALD T O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
112 BALA AVE, BALA CYNWYD, PA 19004-3025
(610) 667-6490
(610) 667-1744
Mailing address
112 BALA AVE, BALA CYNWYD, PA 19004-3025
(610) 667-6490
(610) 667-1744
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS004240L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097182000
MAGELLAN BEHAVIORAL HEALT
PA
01
—
OB022399
BLUESHIELD
PA
Enumeration date
08/02/2006
Last updated
12/04/2009
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