Graduated: 1982
NPI: 1316967060
Practice Locations (2)
104 EGYPT RD
JEFFERSONVILLE, PA 194033029
6102775022
HAVEN BEHAVIORAL SERVICES OF PHILADELPHIA, LLC
3300 HENRY AVE, UNIT 4
PHILADELPHIA, PA 191291141
2154753400
Source: CMS National Downloadable File, September 2026.