Individual
MS. FERNANDA ANN FORMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8220 CASTOR AVE, PHILADELPHIA, PA 19152-2729
(267) 366-8806
(215) 745-6511
Mailing address
8220 CASTOR AVE, PHILADELPHIA, PA 19152-2729
(267) 366-8806
(215) 745-6511
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/07/2020
Last updated
05/07/2020
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