Organization
ESTADT PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY JOHN ESTADT PSY.D. (OWNER)
(267) 304-3414
Entity
Organization
Contact information
Practice address
1930 S BROAD ST, PHILADELPHIA, PA 19145-2328
(267) 304-3414
Mailing address
2926 S 15TH ST, PHILADELPHIA, PA 19145-4917
(267) 304-3414
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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