Individual
DR. DORIS JEANETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
503 S 21ST ST, PHILADELPHIA, PA 19146-1325
(215) 732-6197
Mailing address
503 S 21ST ST, PHILADELPHIA, PA 19146-1325
(215) 732-6197
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-002579-L
PA
Other
Enumeration date
01/08/2008
Last updated
01/08/2008
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