Organization
MYCOCUN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MORGAN RAKAY MA, LPC, BC-DMT (CLINICAL DIRECTOR & DEVELOPMENT)
(267) 908-4664
Entity
Organization
Contact information
Practice address
115 RED OAK DR, LINCOLN UNIVERSITY, PA 19352-8939
(267) 908-4664
Mailing address
115 RED OAK DR, LINCOLN UNIVERSITY, PA 19352-8939
(672) 908-4664
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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