Individual
HEIDI L MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4641 ROOSEVELT BLVD, ORLEANS BLDG, PHILADELPHIA, PA 19124-2343
(215) 831-2836
(215) 831-2929
Mailing address
4641 ROOSEVELT BLVD, ORLEANS BLDG, PHILADELPHIA, PA 19124-2343
(215) 831-2836
(215) 831-2929
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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