Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC010959 | PA |
NPI | 1003388133 |
---|---|
Provider Name | Jillian Altomare |
First Address | North Wales, PA 19454-1720 |
Second Address | Haverford, PA 19041-1139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2018 |
Last Update Date | 31/12/2018 |