Provider Demographics
NPI:1104275098
Name:CONSTANTINIAN, PATRICIA MAGGY (PSYD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MAGGY
Last Name:CONSTANTINIAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 ROBINHOOD RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1239
Mailing Address - Country:US
Mailing Address - Phone:267-342-2099
Mailing Address - Fax:
Practice Address - Street 1:783 ROBINHOOD RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1239
Practice Address - Country:US
Practice Address - Phone:267-342-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017552103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical