Individual
KIMBERLY MACKASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3646 ROSEMONT AVE, DREXEL HILL, PA 19026-2326
(215) 908-2387
Mailing address
3646 ROSEMONT AVE, DREXEL HILL, PA 19026-2326
(215) 908-2387
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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