DOUGLAS FAXON,

PHILADELPHIA, PA
NPI1457863276
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2017-11-02
Last Update Date2017-11-02
Business Address
DOUGLAS FAXON, MS
7657 GILBERT ST
PHILADELPHIA, PA 19150-2605
Phone number: 267-978-1664
Mailing Address
DOUGLAS FAXON, MS
7657 GILBERT ST
PHILADELPHIA, PA 19150-2605
Phone number: 267-978-1664
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