Provider Demographics
NPI:1811130388
Name:FILMORE, ADRIA LAUREN (PSYD)
Entity type:Individual
Prefix:DR
First Name:ADRIA
Middle Name:LAUREN
Last Name:FILMORE
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 1:11 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-4313
Mailing Address - Country:US
Mailing Address - Phone:631-445-3276
Mailing Address - Fax:
Practice Address - Street 1:1518 WALNUT ST
Practice Address - Street 2:SUITE 1604
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3419
Practice Address - Country:US
Practice Address - Phone:631-445-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017063103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical