Provider Demographics
NPI:1366835035
Name:JODI S ROSENFELD, PSYD
Entity Type:Organization
Organization Name:JODI S ROSENFELD, PSYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:484-639-3936
Mailing Address - Street 1:1288 VALLEY FORGE RD
Mailing Address - Street 2:SUITE 83
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2687
Mailing Address - Country:US
Mailing Address - Phone:484-639-3936
Mailing Address - Fax:
Practice Address - Street 1:1288 VALLEY FORGE RD
Practice Address - Street 2:SUITE 83
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2687
Practice Address - Country:US
Practice Address - Phone:484-639-3936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015807103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty