Provider Demographics
NPI:1811993876
Name:GALSON, WENDY R (PSYD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:R
Last Name:GALSON
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 1:434 E MOUNT AIRY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1142
Mailing Address - Country:US
Mailing Address - Phone:215-247-5545
Mailing Address - Fax:215-242-5401
Practice Address - Street 1:434 E MOUNT AIRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1142
Practice Address - Country:US
Practice Address - Phone:215-247-5545
Practice Address - Fax:215-242-5401
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 003772 L103TC0700X
PA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01476130Medicaid
PAGA426707Medicare ID - Type Unspecified