Individual
JAMAL VANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2233-43 WEST ALLEGHENY AVENUE, PHILADELPHIA, PA 19132
(215) 909-1228
Mailing address
15 AVELLA LN, SICKLERVILLE, NJ 08081-1723
(215) 909-1228
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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