Provider Demographics
NPI:1225208283
Name:BLUMENTHAL, DEBORAH RACHEL (PHD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:RACHEL
Last Name:BLUMENTHAL
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 1:1709 VICTORIAN COMMONS
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-860-7001
Mailing Address - Fax:215-702-9550
Practice Address - Street 1:1709 VICTORIAN COMMONS
Practice Address - Street 2:SUITE 2
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-860-7001
Practice Address - Fax:215-702-9550
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015013103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical