| NPI | 1043081029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLASSINGALE COREY Licensed Professional Counselor 215-880-2949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |