Organization
INTEGRATED PSYCHOTHERAPY & ASSESSMENT PRACTICE OF PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN LONDON PH.D (CHIEF EXECUTIVE OFFICER)
(215) 694-3912
Entity
Organization
Contact information
Practice address
405 S 62ND ST, PHILADELPHIA, PA 19143-1031
(215) 694-3912
Mailing address
405 S 62ND ST, PHILADELPHIA, PA 19143-1031
(215) 694-3912
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
08/29/2020
Last updated
08/29/2020
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