Individual
MITRA YAZDI GILBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D,, MS
Contact information
Practice address
801 W GIRARD AVE, STE#103, PHILADELPHIA, PA 19122-4212
(215) 787-2599
Mailing address
PO BOX 18839, PHILADELPHIA, PA 19119-0839
(610) 844-6511
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
35SI00601800
NJ
103T00000X
Psychologist
Primary
PS017057
PA
Other
Enumeration date
09/14/2012
Last updated
05/18/2021
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