| NPI | 1174808646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMAC SORAYA HOLMES Director 215-696-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00398600) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2011-10-17 |