Individual
YURIKO MATSUO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 HENRY AVE, PHILADELPHIA, PA 19129
(215) 254-2069
Mailing address
3300 HENRY AVE, PHILADELPHIA, PA 19129
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP021563
PA
Other
Enumeration date
02/21/2020
Last updated
02/21/2020
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