Individual
AMIRAH MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
154 BICKLEY RD FL 3, GLENSIDE, PA 19038-4537
(215) 206-3358
Mailing address
154 BICKLEY RD FL 3, GLENSIDE, PA 19038-4537
(215) 206-3358
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH007060
PA
Other
Enumeration date
04/18/2024
Last updated
04/18/2024
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