Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | ||
N | 225C00000X | Rehabilitation Counselor | 4940480 | PA |
NPI | 1124670823 |
---|---|
Provider Name | Teresa Mg Massey |
First Address | Phoenixville, PA 19460-4342 |
Second Address | Phoenixville, PA 19460-4342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2019 |
Last Update Date | 12/07/2019 |