Consulting & Therapeutic Modalities INC
Psychologist, Counseling in Bala Cynwyd, PA. Organization (NPI-2).
NPI number1790774248
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1790774248
- Entity type
- Organization (NPI-2)
- Legal business name
- Consulting & Therapeutic Modalities INC
- Organization subpart
- No
- Enumeration date
- Oct 18, 2005
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC1900X | Psychologist, Counseling | PS2609L | PA | Yes |
| 103TC1900X | Psychologist, Counseling | B10000525 | DE |
Other names
- Roman J Pastushak (Other Name)
Practice location
555 City AveSte 210
Bala Cynwyd, PA 19004-1141
Phone 610-660-8338 · Fax 610-660-8339
Mailing address
67 Cynthia DrRichboro, PA 18954-1331
Phone 215-364-1799
Authorized official
Roman Joseph Pastushak
Pres Sole Owner
2153641799
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