Individual
AYESHA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS,LBS,LPC
Contact information
Practice address
7675 WOODCREST AVE, PHILADELPHIA, PA 19151-2703
(267) 471-1047
Mailing address
7675 WOODCREST AVE, PHILADELPHIA, PA 19151-2703
(267) 471-1047
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PCO17648
PA
103K00000X
Behavior Analyst
Primary
BH000483
PA
Other
Enumeration date
03/31/2014
Last updated
10/03/2024
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