Organization
DIVERSIFIED PSYCHOLOGICAL RESOURCES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LAWRENCE RIDER PH.D. (OWNER)
(215) 988-9911
Entity
Organization
Contact information
Practice address
230 S. BROAD ST., SUITE 1005, PHILADELPHIA, PA 19102-4105
(215) 988-9911
(215) 988-9912
Mailing address
230 S. BROAD ST., SUITE 1005, PHILADELPHIA, PA 19102-4105
(215) 988-9911
(215) 988-9912
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS003688-L
PA
103T00000X
Psychologist
PS003688-L
PA
103TC0700X
Clinical Psychologist
PS003688-L
PA
Other
Enumeration date
01/05/2007
Last updated
09/16/2022
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