Individual
ARNOLD TIM MASSAQUOI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
461 AURANIA ST, PHILADELPHIA, PA 19128-4010
(484) 951-4513
Mailing address
461 AURANIA ST, PHILADELPHIA, PA 19128-4010
(484) 951-4513
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC011912
PA
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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