Individual
DR. CHRIS GUS DEMATATIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHRIS DEMATATIS
Contact information
Practice address
191 PRESIDENTIAL BLVD, SUITE 124, BALA CYNWYD, PA 19004-1207
(610) 667-5829
(610) 667-3438
Mailing address
191 PRESIDENTIAL BLVD, SUITE 124, BALA CYNWYD, PA 19004-1207
(610) 667-5829
(610) 667-3438
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS-003889-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS-003889-L
STATE LICENSE NUMBER
PA
Enumeration date
01/08/2007
Last updated
07/08/2007
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