Provider Demographics
NPI:1669694196
Name:HERMANN, ALGUND NA (PHD)
Entity type:Individual
Prefix:DR
First Name:ALGUND
Middle Name:NA
Last Name:HERMANN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 WALNUT STREET
Mailing Address - Street 2:SUITE 1515
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PR
Mailing Address - Zip Code:19102-1042
Mailing Address - Country:US
Mailing Address - Phone:215-299-1234
Mailing Address - Fax:215-199-1288
Practice Address - Street 1:1601 WALNUT STREET
Practice Address - Street 2:SUITE 1515
Practice Address - City:PHILADELPHIA
Practice Address - State:PR
Practice Address - Zip Code:19102-1042
Practice Address - Country:US
Practice Address - Phone:215-299-1234
Practice Address - Fax:215-199-1288
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004042L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist