| NPI | 1053770131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENINE JOHNSON Sole Mbr 215-703-7865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC007758) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |