Provider First Line Business Practice Location Address:
100 EAST LEHIGH AVENUE - DEPT. OF PSYCHOLOGY
Provider Second Line Business Practice Location Address:
MAB BLDG, SUITE 105
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-707-8496
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2007