Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1063187201 |
---|---|
Provider Name | Christine Lombardo |
First Address | Media, PA 19063-5234 |
Second Address | Exton, PA 19341-2828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2021 |
Last Update Date | 10/08/2021 |