Organization
OPTIMAL HEALTH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNE NISENZON PH.D. (OWNER)
(267) 540-8583
Entity
Organization
Contact information
Practice address
1528 WALNUT ST STE 1402, PHILADELPHIA, PA 19102-3610
(267) 540-8583
Mailing address
1528 WALNUT ST STE 1402, PHILADELPHIA, PA 19102-3610
(267) 540-8583
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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