| Agnese Psychological, Inc. | |
|
54 Friends Ln Ste 114 Newtown PA 18940-3403 | |
| (267) 229-6237 | |
| Not Available |
| Full Name | Agnese Psychological, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 54 Friends Ln Ste 114, Newtown, Pennsylvania |
| Authorized Official Name and Position | Christine Marie Etzrodt (OWNER) |
| Authorized Official Contact | 2672296237 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agnese Psychological, Inc. 54 Friends Ln Ste 114 Newtown PA 18940-3403 Ph: (267) 229-6237 | Agnese Psychological, Inc. 54 Friends Ln Ste 114 Newtown PA 18940-3403 Ph: (267) 229-6237 |
| NPI Number | 1528568615 |
|---|---|
| Provider Enumeration Date | 02/15/2018 |
| Last Update Date | 02/02/2019 |
| Medicare PECOS PAC ID | 5193087229 |
|---|---|
| Medicare Enrollment ID | O20180329000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528568615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PS018437 (Pennsylvania) | Primary |
| Provider Name | Christine Marie Etzrodt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821505611 PECOS PAC ID: 6002178134 Enrollment ID: I20180329000601 |
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