Individual
FADY PHILIP MICHAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LAC
Contact information
Practice address
2109 PENNINGTON RD, EWING, NJ 08638-1400
(610) 644-6464
(610) 981-6078
Mailing address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
(610) 981-6078
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37AC00124300
NJ
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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