Provider Demographics
NPI:1679807531
Name:THE CENTER FOR EMOTIONAL HEALTH OF GREATER PHILADELPHIA, LLC
Entity Type:Organization
Organization Name:THE CENTER FOR EMOTIONAL HEALTH OF GREATER PHILADELPHIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:WAX
Authorized Official - Last Name:DEIBLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:856-220-9672
Mailing Address - Street 1:385 N KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1013
Mailing Address - Country:US
Mailing Address - Phone:856-220-9672
Mailing Address - Fax:
Practice Address - Street 1:385 N KINGS HWY
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1013
Practice Address - Country:US
Practice Address - Phone:856-220-9672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00438000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty