| Professional Clinical Forum | |
|
142 E Moreland Ave Pcf Managing Partner Hatboro PA 19040-4714 | |
| (215) 956-0334 | |
| (215) 956-0308 |
| Full Name | Professional Clinical Forum |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 142 E Moreland Ave, Hatboro, Pennsylvania |
| Authorized Official Name and Position | Michael John Mulligan (MANAGING PARTNER) |
| Authorized Official Contact | 2159560334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Clinical Forum 142 E Moreland Ave Pcf Managing Partner Hatboro PA 19040-4714 Ph: (215) 956-0334 | Professional Clinical Forum 142 E Moreland Ave Pcf Managing Partner Hatboro PA 19040-4714 Ph: (215) 956-0334 |
| NPI Number | 1982766564 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982766564 | NPI | - | NPPES |
| 0162452900001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS001156L (Pennsylvania) | Primary |
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