Individual
DOMENICA M KNUDSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
280 N PROVIDENCE RD, MEDIA, PA 19063-3527
(610) 565-6843
Mailing address
280 N PROVIDENCE RD, MEDIA, PA 19063-3527
(610) 565-6843
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
B1-0000679
DE
103TC0700X
Clinical Psychologist
Primary
PS008547L
PA
Other
Enumeration date
03/24/2006
Last updated
06/07/2011
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