Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PS016908 | PA |
NPI | 1043502503 |
---|---|
Provider Name | Dr. Kristen Ann Caprara |
First Address | Philadelphia, PA 19147-4528 |
Second Address | Jenkintown, PA 19046-3925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2011 |
Last Update Date | 03/05/2011 |