| NPI | 1114489432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRICE R. LEWIS Licensed Professional Counselor 215-687-7050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2021-05-19 |