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1457863276
DOUGLAS FAXON,
PHILADELPHIA, PA
NPI
1457863276
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-11-02
Last Update Date
2017-11-02
Business Address
DOUGLAS FAXON, MS
7657 GILBERT ST
PHILADELPHIA, PA 19150-2605
Phone number: 267-978-1664
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Mailing Address
DOUGLAS FAXON, MS
7657 GILBERT ST
PHILADELPHIA, PA 19150-2605
Phone number: 267-978-1664
Copy
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