Individual
DR. MARTA RUSTEN MACDOUGALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
512 WEST AVE, JENKINTOWN, PA 19046-2725
(215) 885-1835
(215) 885-8510
Mailing address
498 LINCOLN AVE, WILLOW GROVE, PA 19090-2636
(215) 657-1810
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS015570
PA
Other
Enumeration date
01/14/2007
Last updated
07/08/2007
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