Provider Demographics
NPI:1942329875
Name:DILL-STANDIFORD PSYCHOLOGICAL SERVICES, INC,
Entity Type:Organization
Organization Name:DILL-STANDIFORD PSYCHOLOGICAL SERVICES, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DILL-STANDIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-752-3268
Mailing Address - Street 1:241 WEST MAPLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2131
Mailing Address - Country:US
Mailing Address - Phone:215-752-3268
Mailing Address - Fax:
Practice Address - Street 1:241 WEST MAPLE AVENUE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2131
Practice Address - Country:US
Practice Address - Phone:215-752-3268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008085L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty