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1346066859
MERCEDES JULIA DETTRA
PHILADELPHIA, PA
NPI
1346066859
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: PA SP031168)
Enumeration Date
2024-11-30
Last Update Date
2024-11-30
Business Address
MERCEDES JULIA DETTRA PMHNP
111 N 49TH ST
PHILADELPHIA, PA 19139-2718
Phone number: 215-471-2600
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Mailing Address
MERCEDES JULIA DETTRA PMHNP
913 S 51ST ST APT 4
PHILADELPHIA, PA 19143-3260
Phone number: 267-650-5454
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