Organization
OVERBROOK THERAPY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARISSA Y FERGUSON PSY.D, LCSW (PRESIDENT/CEO)
(215) 510-1063
Entity
Organization
Contact information
Practice address
1015 WEST 24TH STREET, WILMINGTON, DE 19802
(302) 834-5433
Mailing address
PO BOX 53726, PHILADELPHIA, PA 19105-3726
(215) 510-1063
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
Q10000903
DE
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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