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Individual

JOSEPH THOMAS CONNELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1414 UNRUH AVE, PHILADELPHIA, PA 19111-4910
(215) 742-0554
Mailing address
1414 UNRUH AVE, PHILADELPHIA, PA 19111-4910

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS003268L
PA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PS003268L
PA
106H00000X
Marriage & Family Therapist
PS003268L
PA

Other

Enumeration date
04/24/2008
Last updated
04/24/2008
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