Provider Demographics
NPI:1487082111
Name:PASCAL, JOANNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:PASCAL
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 1:2035 CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2616
Mailing Address - Country:US
Mailing Address - Phone:917-572-0808
Mailing Address - Fax:
Practice Address - Street 1:1088 WEST BALTIMORE PIKE HCC II, STE 2205
Practice Address - Street 2:CENTER FOR NEUROSCIENCE, RIDDLE HOSPITAL
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063
Practice Address - Country:US
Practice Address - Phone:610-744-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017452103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist