Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS005737L | PA |
Y | 103TC0700X | Clinical Psychologist | PS005737L | PA |
NPI | 1003030479 |
---|---|
Provider Name | Thomas A Bartlett |
First Address | Philadelphia, PA 19146-1518 |
Second Address | Philadelphia, PA 19146-1518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 08/07/2007 |