Individual
DR. ANDREA DALE MINER-ISAACSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
822 MONTGOMERY AVE, #301, NARBERTH, PA 19072-1937
(610) 664-1424
(610) 664-1424
Mailing address
416 HEATHERWOOD RD, HAVERTOWN, PA 19083-5539
(610) 446-4981
(610) 446-4298
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS005844L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0469820000
PERSONAL CHOICE
PA
Enumeration date
03/08/2007
Last updated
07/08/2007
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