Individual
ALICE D GRESHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2025 CONLYN ST, PHILADELPHIA, PA 19138-2925
(936) 662-7478
Mailing address
2025 CONLYN ST, PHILADELPHIA, PA 19138-2925
(936) 662-7478
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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