Individual
DR. MARY ELIZABETH ERTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1024 E LANCASTER AVE, BRYN MAWR, PA 19010-1409
(610) 525-1599
(610) 525-1599
Mailing address
1024 E LANCASTER AVE, BRYN MAWR, PA 19010-1409
(610) 525-1599
(610) 525-1599
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS016105
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3010503
PA ACT 48 PROFESSIONAL PERSONNEL ID
PA
01
—
PS016105
PA STATE LICENSE NUMBER
PA
Enumeration date
06/30/2011
Last updated
06/30/2011
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