Individual
AVERY AXEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
525 S 4TH ST STE 471, PHILADELPHIA, PA 19147-1582
(267) 861-3685
Mailing address
525 S 4TH ST STE 471, PHILADELPHIA, PA 19147-1582
(267) 861-3685
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS018896
PA
Other
Enumeration date
05/02/2017
Last updated
09/10/2025
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