Individual
DR. ALISSA BETH JERUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4618 HAZEL AVE, PHILADELPHIA, PA 19143-2104
(206) 501-8794
Mailing address
4618 HAZEL AVE, PHILADELPHIA, PA 19143-2104
(206) 501-8794
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS018588
PA
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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