Individual
CAITLIN PARK-DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4865 MARKET ST, PHILADELPHIA, PA 19139-3508
(610) 551-3163
Mailing address
3220 POTTER ST, PHILADELPHIA, PA 19134-1922
(574) 377-2965
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC011666
PA
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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