Individual
ALEXANDER RYN NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21 S 11TH ST, PHILADELPHIA, PA 19107-4223
(267) 603-7126
Mailing address
5103 HAZEL AVE APT 2, PHILADELPHIA, PA 19143-1540
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW140442
—
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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