Provider Demographics
NPI:1184836553
Name:REISKIND, NAOMI (PHD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:
Last Name:REISKIND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 HAGYS FORD RD
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1101
Mailing Address - Country:US
Mailing Address - Phone:610-667-8699
Mailing Address - Fax:
Practice Address - Street 1:1123 HAGYS FORD RD
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1101
Practice Address - Country:US
Practice Address - Phone:610-667-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS001939L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical