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Organization

ACHIEVING NIRVANA LLC

Active
Other names
Amber Pham
Organization subpart
No

Provider details

NPI number
Authorized official
AMBER PHAM LCSW (THERAPIST)
(267) 630-4688
Entity
Organization

Contact information

Practice address
2402 BROWNING RD, PENNSAUKEN, NJ 08110-1917
(267) 630-4688
Mailing address
2402 BROWNING RD, PENNSAUKEN, NJ 08110-1917

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0450498715
CERTIFICATION OF FORMATION
NJ
Enumeration date
08/06/2020
Last updated
08/06/2020
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