Individual
MR. JAMES ANTHONY BASILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
313 S 16TH ASTREET, PHILADELPHIA, PA 19102-4908
(215) 732-8244
(215) 732-8454
Mailing address
1441 MICHIGAN AVE, SWARTHMORE, PA 19081-2718
(484) 431-8689
(215) 732-8454
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC006075
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC006075
LPC LICENSE
PA
Enumeration date
10/28/2011
Last updated
10/28/2011
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