Provider Demographics
NPI:1275691701
Name:CLEARY, EILEEN MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:MARIE
Last Name:CLEARY
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 1:131 SHELLEY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2422
Mailing Address - Country:US
Mailing Address - Phone:215-942-9230
Mailing Address - Fax:
Practice Address - Street 1:1703 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 6
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1082
Practice Address - Country:US
Practice Address - Phone:215-942-9231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-008166-L103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical