Individual
JOHN STANLEY RAJ CHINNAIYAN MATHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6930 MARKET ST, UPPER DARBY, PA 19082-2308
(484) 469-4319
Mailing address
160 BETHLEHEM PIKE, COLMAR, PA 18915-9790
(215) 997-2000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BH001686
PA
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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