| Lift Off Therapy Center Llc | |
|
121 N Wayne Ave Ste 304 Wayne PA 19087-3542 | |
| (610) 601-2748 | |
| (508) 433-1871 |
| Full Name | Lift Off Therapy Center Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 121 N Wayne Ave Ste 304, Wayne, Pennsylvania |
| Authorized Official Name and Position | Brian Robert Mcmanus (OWNER) |
| Authorized Official Contact | 6106012748 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lift Off Therapy Center Llc 403 Country Ln Narberth PA 19072-2121 Ph: (610) 601-2748 | Lift Off Therapy Center Llc 121 N Wayne Ave Ste 304 Wayne PA 19087-3542 Ph: (610) 601-2748 |
| NPI Number | 1225653744 |
|---|---|
| Provider Enumeration Date | 06/10/2020 |
| Last Update Date | 06/10/2020 |
| Certification Date | 06/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225653744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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