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GREGORY J ESTADT PHD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY J ESTADT PHD (OWNER)
(267) 304-3414
Entity
Organization

Contact information

Practice address
331 W STATE ST, MEDIA, PA 19063-2615
(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
PS016426
PA

Other

Enumeration date
05/27/2011
Last updated
05/27/2011
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