Individual
FRED BRIAN CHASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
135 S 19TH ST, SUITE 240, PHILA, PA 19103-4912
(215) 561-0202
(856) 745-9008
Mailing address
135 S 19TH ST, PHILA, PA 19103-4912
(215) 561-0202
(856) 745-9008
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
003384
PA
103T00000X
Psychologist
028494
NJ
Other
Enumeration date
08/07/2006
Last updated
09/09/2012
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