Individual
AUTUMN SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LCGC
Contact information
Practice address
1600 ROCKLAND RD, WILMINGTON, DE 19803-3607
(302) 553-7362
Mailing address
921 LOMBARD ST APT B, PHILADELPHIA, PA 19147-1259
(704) 500-9177
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
CG-0010538
DE
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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