Individual
DR. SOUMYA MADABHUSHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1424 FAIRMOUNT AVE APT 309, PHILADELPHIA, PA 19130-2955
(732) 877-7928
Mailing address
1424 FAIRMOUNT AVE APT 309, PHILADELPHIA, PA 19130-2955
(732) 877-7928
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS017562
PA
Other
Enumeration date
05/02/2007
Last updated
07/16/2020
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