Individual
EVIN SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 EDISON AVE, PHILADELPHIA, PA 19116-1237
(215) 673-5700
Mailing address
650 EDISON AVE, PHILADELPHIA, PA 19116-1237
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL012128
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/27/2014
Last updated
08/03/2015
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