Individual
KYRA JOHANA SJARIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 S 17TH ST STE 2121, PHILADELPHIA, PA 19103-6211
(267) 603-1203
Mailing address
709 S MARVINE ST, PHILADELPHIA, PA 19147-1913
(510) 371-3073
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC012595
PA
Other
Enumeration date
08/05/2020
Last updated
11/08/2024
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