Individual
DR. JESSICA LAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
10541 DRUMMOND RD, PHILADELPHIA, PA 19154
(215) 612-7573
(215) 632-6426
Mailing address
2005 CABOT BLVD W, LANGHORNE, PA 19047-1885
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS018819
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23-1742920
—
PA
Enumeration date
05/10/2013
Last updated
07/22/2019
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