Provider Demographics
NPI:1619910064
Name:ANGERT, MARLENE RUBIN (EDD)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:RUBIN
Last Name:ANGERT
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:MARLENE
Other - Middle Name:RUBIN
Other - Last Name:ANGERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:116 YEW RD
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1204
Mailing Address - Country:US
Mailing Address - Phone:215-663-5610
Mailing Address - Fax:215-663-5610
Practice Address - Street 1:116 YEW RD
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1204
Practice Address - Country:US
Practice Address - Phone:215-663-5610
Practice Address - Fax:215-663-5610
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006082L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist