Provider Demographics
NPI:1750361937
Name:LEVITT, MARJORY JAYE (PHD)
Entity type:Individual
Prefix:DR
First Name:MARJORY
Middle Name:JAYE
Last Name:LEVITT
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 1:326 W EARLHAM TER
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3920
Mailing Address - Country:US
Mailing Address - Phone:215-848-7889
Mailing Address - Fax:215-848-8566
Practice Address - Street 1:326 W EARLHAM TER
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3920
Practice Address - Country:US
Practice Address - Phone:215-848-7889
Practice Address - Fax:215-848-8566
Is Sole Proprietor?:No
Enumeration Date:2006-01-22
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008316L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist