Basic Information
| Provider Information | |||||||||
| NPI: | 1720722341 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARTESSA | ||||||||
| FirstName: | LIANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD, MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 278 DELMAR ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191284501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157204793 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4601 MARKET ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191394636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155907555 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2022 | ||||||||
| LastUpdateDate: | 04/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.