Provider Demographics
NPI:1457402570
Name:HYMAN, MICHELE A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:A
Last Name:HYMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1798 MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1908
Mailing Address - Country:US
Mailing Address - Phone:610-812-8160
Mailing Address - Fax:
Practice Address - Street 1:319 W FRONT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2340
Practice Address - Country:US
Practice Address - Phone:610-812-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009182103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00287352OtherRAILROAD MEDICARE
PAP00287352OtherRAILROAD MEDICARE