Individual
AMY MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
6060 RIDGE AVE STE 210, PHILADELPHIA, PA 19128-1660
(267) 627-4610
Mailing address
6060 RIDGE AVE STE 210, PHILADELPHIA, PA 19128-1660
(267) 627-4610
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/05/2020
Last updated
08/24/2021
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