Provider Demographics
NPI:1578312997
Name:ROBERTS-DONNELLY, HADLEY
Entity type:Individual
Prefix:
First Name:HADLEY
Middle Name:
Last Name:ROBERTS-DONNELLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 SOUTH ST
Mailing Address - Street 2:#2F
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1434
Mailing Address - Country:US
Mailing Address - Phone:510-859-4404
Mailing Address - Fax:
Practice Address - Street 1:1904 SOUTH ST
Practice Address - Street 2:#2F
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1434
Practice Address - Country:US
Practice Address - Phone:510-859-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health