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Organization

TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION

Active
Other names
Temple Psychology Associates
Organization subpart
No

Provider details

NPI number
Authorized official
TONYA WOODARD (CREDENTIALING/MANAGER)
(215) 707-3911
Entity
Organization

Contact information

Practice address
100 E LEHIGH AVE BLDG STE 105, PHILADELPHIA, PA 19125-1012
(215) 707-8496
(215) 707-4086
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-8496
(215) 707-4086

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007780130699
PA
05
1007780130752
PA
05
1007780130753
PA
Enumeration date
10/12/2005
Last updated
06/15/2018
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