Organization
FULL SPECTRUM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCY A SHOEMAKER PSY.D. (OWNER)
(215) 313-0057
Entity
Organization
Contact information
Practice address
925 ROSCOMMON RD, BRYN MAWR, PA 19010-1842
(215) 313-0057
Mailing address
925 ROSCOMMON RD, BRYN MAWR, PA 19010
(215) 313-0057
(610) 520-5205
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTAN 039191
MEDICARE PTAN: 039191
PA
Enumeration date
11/03/2009
Last updated
01/30/2025
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