Individual
JEFFREY WOLPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
1800 JOHN F KENNEDY BLVD, SUITE 605, PHILADELPHIA, PA 19103-7421
(267) 977-0850
(215) 322-6067
Mailing address
1800 JOHN F KENNEDY BLVD, SUITE 605, PHILADELPHIA, PA 19103-7421
(267) 977-0850
(215) 322-6067
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS005921L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500938000
PERSONAL CHOICE
PA
01
—
668005
PA BLUE SHIELD
PA
Enumeration date
09/14/2006
Last updated
07/08/2007
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