Individual
CAMELLIA HEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
239 MONTROSE ST, PHILADELPHIA, PA 19147-4226
(678) 200-6327
Mailing address
239 MONTROSE ST, PHILADELPHIA, PA 19147-4226
(678) 200-6327
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW137339
PA
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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