Provider Demographics
NPI:1851432934
Name:ERLICH, LINDA P (MA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:P
Last Name:ERLICH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LEGACY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-2201
Mailing Address - Country:US
Mailing Address - Phone:215-355-7886
Mailing Address - Fax:215-355-6410
Practice Address - Street 1:333 N OXFORD VALLEY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-2624
Practice Address - Country:US
Practice Address - Phone:215-547-5774
Practice Address - Fax:215-957-0768
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007100L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAR07222Medicare ID - Type Unspecified