Growup | |
100 W Main St Suite 435 Lansdale PA 19446-2019 | |
(267) 273-8041 | |
Not Available |
Full Name | Growup |
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Speciality | Psychologist - Clinical |
Location | 100 W Main St, Lansdale, Pennsylvania |
Authorized Official Name and Position | Leela Jackson (LICENSED CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 2672738041 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Growup 345 Leverington Ave Philadelphia PA 19128-4738 Ph: () - | Growup 100 W Main St Suite 435 Lansdale PA 19446-2019 Ph: (267) 273-8041 |
NPI Number | 1104299767 |
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Provider Enumeration Date | 11/04/2015 |
Last Update Date | 11/04/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104299767 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | PS017033 (Pennsylvania) | Primary |
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