Individual
BLAKEN WAMSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8220 CASTOR AVE, PHILADELPHIA, PA 19152-2729
(267) 366-8807
Mailing address
8220 CASTOR AVE, PHILADELPHIA, PA 19152-2729
(267) 366-8807
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NA
—
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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