Provider Demographics
NPI:1578660643
Name:EDGETTE, JANET SASSON (PSYD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:SASSON
Last Name:EDGETTE
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 1:660 EXTON CMNS
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2446
Mailing Address - Country:US
Mailing Address - Phone:610-363-8717
Mailing Address - Fax:610-430-8307
Practice Address - Street 1:660 EXTON CMNS
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2446
Practice Address - Country:US
Practice Address - Phone:610-363-8717
Practice Address - Fax:610-430-8307
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005249-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist