Organization
PROFESSIONAL CLINICAL FORUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JOHN MULLIGAN III (MANAGING PARTNER)
(215) 956-0334
Entity
Organization
Contact information
Practice address
142 E MORELAND AVE, PCF MANAGING PARTNER, HATBORO, PA 19040-4714
(215) 956-0334
(215) 956-0308
Mailing address
142 E MORELAND AVE, PCF MANAGING PARTNER, HATBORO, PA 19040-4714
(215) 956-0334
(215) 956-0308
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS001156L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0162452900001
—
PA
Enumeration date
12/13/2006
Last updated
08/22/2020
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