Healthcare Provider Details

I. General information

NPI: 1952581159
Provider Name (Legal Business Name): CHARLOTTE L WROTON M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2514 N BROAD ST
PHILADELPHIA PA
19132-4013
US

IV. Provider business mailing address

2514 N BROAD ST
PHILADELPHIA PA
19132-4013
US

V. Phone/Fax

Practice location:
  • Phone: 215-599-2801
  • Fax: 215-599-1043
Mailing address:
  • Phone: 215-599-2801
  • Fax: 215-599-1043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: