Provider Demographics
NPI:1437713476
Name:DUTTA, RICHA AGGARWAL (PHD)
Entity Type:Individual
Prefix:
First Name:RICHA
Middle Name:AGGARWAL
Last Name:DUTTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:RICHA
Other - Middle Name:
Other - Last Name:AGGARWAL DUTTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:721 WALNUT ST APT 304
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3243
Mailing Address - Country:US
Mailing Address - Phone:757-753-2158
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist