| NPI | 1730970534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDRA GHAFOOR Member/Co Owner 215-217-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 2084S0010X Psychiatry & Neurology, Sports Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 104100000X Social Worker | |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-05-18 |