Individual
THERESA NIEDOSIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3044 BRIGHTON ST, PHILADELPHIA, PA 19149-1924
(609) 432-9425
Mailing address
3044 BRIGHTON ST, PHILADELPHIA, PA 19149-1924
(609) 432-9425
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
PA
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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