| NPI | 1346473196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK F NELSON Provider Relations 215-904-8748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2010-06-22 |