Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1104293166 |
---|---|
Provider Name | Christina Taymullah |
First Address | Glenolden, PA 19036-0366 |
Second Address | Montgomeryville, PA 18936-9710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2015 |
Last Update Date | 26/08/2015 |