Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PSO15683 | PA |
NPI | 1053538918 |
---|---|
Provider Name | Dr. Larina Kase |
First Address | Philadelphia, PA 19127-1258 |
Second Address | Plymouth Meeting, PA 19462-1946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |