Organization
BELIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANE SAUNDERS PSY.D. (CLINICAL DIRECTOR)
(267) 304-6652
Entity
Organization
Contact information
Practice address
2227 N BROAD ST, PHILADELPHIA, PA 19132-4502
(267) 304-6652
Mailing address
240 E MONTGOMERY AVE UNIT 12, ARDMORE, PA 19003-3322
(267) 304-6652
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316453533
INDEPENDENCE BLUE CROSS
—
Enumeration date
02/25/2021
Last updated
02/25/2021
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