Individual
JAKE WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
529 FERN ST, YEADON, PA 19050-3225
(610) 623-0715
Mailing address
529 FERN ST, YEADON, PA 19050-3225
(610) 623-0715
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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