Organization
MAIN LINE NEUROPSYCHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER BADGLEY PHD (OWNER/NEUROPSYCHOLOGIST)
(610) 500-4700
Entity
Organization
Contact information
Practice address
30 S VALLEY RD, SUITE 207, PAOLI, PA 19301-1450
(610) 500-4700
Mailing address
43 PAOLI PLZ UNIT 1448, PAOLI, PA 19301-5044
(610) 500-4700
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS016840
PA
103T00000X
Psychologist
PS016840
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS016840
PA
103TC0700X
Clinical Psychologist
PS016840
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PS016840
PA
103TH0100X
Health Service Psychologist
PS016840
PA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PS016840
PA
Other
Enumeration date
05/24/2011
Last updated
03/18/2016
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