Individual
DR. THERON C MALE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1515 W CHESTER PIKE, STE D-2, WEST CHESTER, PA 19382-7783
(610) 692-2092
(610) 692-2863
Mailing address
1515 W CHESTER PIKE, STE D-2, WEST CHESTER, PA 19382-7783
(610) 692-2092
(610) 692-2863
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS000850L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS000850L
—
PA
Enumeration date
01/30/2006
Last updated
07/09/2007
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