Provider Demographics
NPI:1083903629
Name:INTEGRATIVE PSYCHOLOGY SOLUTIONS PC
Entity Type:Organization
Organization Name:INTEGRATIVE PSYCHOLOGY SOLUTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:DORLEN
Authorized Official - Last Name:PASTOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:609-462-4677
Mailing Address - Street 1:20 SUFFOLK LN
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1226
Mailing Address - Country:US
Mailing Address - Phone:609-462-4677
Mailing Address - Fax:
Practice Address - Street 1:20 NASSAU ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-4509
Practice Address - Country:US
Practice Address - Phone:609-462-4677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty