Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 3112-57 | WI |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PS017601 | PA |
NPI | 1023202710 |
---|---|
Provider Name | Dina Karvounides |
First Address | Philadelphia, PA 19104 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2007 |
Last Update Date | 27/07/2016 |