Provider Demographics
NPI:1326639055
Name:CICI GOKALTUN, AYSE
Entity Type:Individual
Prefix:DR
First Name:AYSE
Middle Name:
Last Name:CICI GOKALTUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 NICOLE DR
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1427
Mailing Address - Country:US
Mailing Address - Phone:786-301-1935
Mailing Address - Fax:
Practice Address - Street 1:882 JACKSONVILLE RD
Practice Address - Street 2:
Practice Address - City:IVYLAND
Practice Address - State:PA
Practice Address - Zip Code:18974-4807
Practice Address - Country:US
Practice Address - Phone:215-355-2011
Practice Address - Fax:215-396-1886
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No101Y00000XBehavioral Health & Social Service ProvidersCounselor