Provider Demographics
NPI:1750719928
Name:RICHETTI, MEGHAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:
Last Name:RICHETTI
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 1:414 PAOLI PIKE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3311
Mailing Address - Country:US
Mailing Address - Phone:484-596-5430
Mailing Address - Fax:610-296-3788
Practice Address - Street 1:414 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3311
Practice Address - Country:US
Practice Address - Phone:484-596-5430
Practice Address - Fax:610-296-3788
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017469103TC0700X
VA0810004870103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical