Provider Demographics
NPI:1164038402
Name:SIFFIN, KARLY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KARLY
Middle Name:
Last Name:SIFFIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7170 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2301
Mailing Address - Country:US
Mailing Address - Phone:215-653-7894
Mailing Address - Fax:
Practice Address - Street 1:7170 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2301
Practice Address - Country:US
Practice Address - Phone:215-653-7894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019112103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical