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Mimiko Watanabe
Clinical Psychologist in Philadelphia, Pennsylvania
NPI 1528437704

Mimiko Watanabe is a Clinical Psychologist based in Upper Darby, PA and is specialized in Clinical. Mimiko Watanabe practices in Philadelphia, PA. The NPI Number for Mimiko Watanabe is 1528437704 and holds a License No. (Pennsylvania).

The current practice location address for Mimiko Watanabe is 1411 S 15Th St, Philadelphia, PA and can be reached out via phone at 646-712-3919.

Location: 1411 S 15Th St, Philadelphia, PA, 19082-4909
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1528437704
Provider Name
Mimiko Watanabe
Credential
Provider Entity Type
Individual
Gender
Female
Address
1411 S 15Th St, Philadelphia, PA, 19082-4909
Phone Number
646-712-3919
Fax Number
Provider Enumeration Date
09/17/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1411 S 15Th St
City
Philadelphia
State
Pennsylvania
Zip
19146-4803
Phone Number
646-712-3919
Fax Number
person
Provider Business Mailing Address Details
Address
1411 S 15Th St
City
Philadelphia
State
Pennsylvania
Zip
19146-4803
Phone Number
646-712-3919
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
PS019468 (Pennsylvania)
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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