Individual
DR. TERRI S LUSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11 BALA AVE, BALA CYNWYD, PA 19004-3201
(610) 668-2290
Mailing address
11 BALA AVE, BALA CYNWYD, PA 19004-3201
(610) 668-2290
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS008431L
PA
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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