Individual
MARISSA J LAVINSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4601 MARKET ST, PHILADELPHIA, PA 19139-4636
(215) 878-3400
Mailing address
4601 MARKET ST, PHILADELPHIA, PA 19139-4636
(215) 878-3400
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS020394
PA
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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