Organization
TARA DEVINENI LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA DEVINENI LCSW (LICENSED CLINICAL SOCIAL WORKER)
(484) 424-7218
Entity
Organization
Contact information
Practice address
1137 LANCASTER AVE, BERWYN, PA 19312-1243
(484) 424-7218
Mailing address
1137 LANCASTER AVE, BERWYN, PA 19312-1243
(484) 424-7218
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
CW019653
PA
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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