Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC011366 | PA |
NPI | 1003438227 |
---|---|
Provider Name | Carolynn Mcnamara |
First Address | Malvern, PA 19355-9618 |
Second Address | Philadelphia, PA 19131-2824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2020 |
Last Update Date | 11/05/2020 |