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Individual

MISS EMILY ENID ALICEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
112 N BROAD ST, 8TH FL, PHILADELPHIA, PA 19102-1510
(215) 568-0860
(215) 568-0769
Mailing address
3147 N SHERIDAN ST, PHILADELPHIA, PA 19133-2442
(215) 350-4285

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/14/2007
Last updated
07/08/2007
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