Provider Demographics
NPI:1922157304
Name:SEGAL, KATHY JOAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:JOAN
Last Name:SEGAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:230 S BROAD STREET
Mailing Address - Street 2:SUITE 600
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-4121
Mailing Address - Country:US
Mailing Address - Phone:215-545-3340
Mailing Address - Fax:215-545-2749
Practice Address - Street 1:230 S BROAD STREET
Practice Address - Street 2:SUITE 600
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4121
Practice Address - Country:US
Practice Address - Phone:215-545-3340
Practice Address - Fax:215-545-2749
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009139L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical