Provider Demographics
NPI:1659312817
Name:DEVIZIA, ANNMARIE (LPC)
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:
Last Name:DEVIZIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 WELSH RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6357
Mailing Address - Country:US
Mailing Address - Phone:215-914-2119
Mailing Address - Fax:215-914-1663
Practice Address - Street 1:8815 GERMANTOWN AVE
Practice Address - Street 2:SUITE 31
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2722
Practice Address - Country:US
Practice Address - Phone:215-242-8155
Practice Address - Fax:215-242-8159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health