Individual
DR. JESSICA RUTSTEIN LAZARUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
8400 ROOSEVELT BLVD, SUITE 206, PHILADELPHIA, PA 19152-2081
(215) 333-7562
Mailing address
39 OVERHILL RD, BALA CYNWYD, PA 19004-2248
(610) 405-8569
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS017605
PA
103TC0700X
Clinical Psychologist
PS017605
PA
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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