Individual
LIZZY ENIGWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1504 E CLIVEDEN ST, PHILADELPHIA, PA 19150-3310
(215) 939-2118
Mailing address
2275 BRIDGE ST BLDG 5, B-132, PHILADELPHIA, PA 19137-2307
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
BH000814
PA
103K00000X
Behavior Analyst
Primary
BH000814
PA
Other
Enumeration date
12/26/2014
Last updated
12/26/2014
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