| Philadelphia Dynamic Therapy LLC | |
|
1518 Walnut St Ste 1604 Philadelphia PA 19102-3409 | |
| (203) 747-1058 | |
| Not Available |
| Full Name | Philadelphia Dynamic Therapy LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1518 Walnut St Ste 1604, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Emma Hazanov (PRESIDENT) |
| Authorized Official Contact | 2037471058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philadelphia Dynamic Therapy LLC 1518 Walnut St Ste 1604 Philadelphia PA 19102-3409 Ph: (203) 747-1058 | Philadelphia Dynamic Therapy LLC 1518 Walnut St Ste 1604 Philadelphia PA 19102-3409 Ph: (203) 747-1058 |
| NPI Number | 1356934921 |
|---|---|
| Provider Enumeration Date | 02/15/2021 |
| Last Update Date | 02/15/2021 |
| Certification Date | 02/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356934921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
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