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1150 First Ave Suite 501 King Of Prussia PA 19406-1334 | |
| (484) 685-0965 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 1150 First Ave, King Of Prussia, Pennsylvania |
| Authorized Official Name and Position | Jutta Vogt (PRESIDENT) |
| Authorized Official Contact | 6107614903 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
21 Llanfair Cir Ardmore PA 19003-3342 Ph: (610) 761-4903 | 1150 First Ave Suite 501 King Of Prussia PA 19406-1334 Ph: (484) 685-0965 |
| NPI Number | 1134540172 |
|---|---|
| Provider Enumeration Date | 12/18/2013 |
| Last Update Date | 12/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134540172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | MD070614-L (Pennsylvania) | Primary |
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