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General NPI Number Information
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NPI Number | 1144820754
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Entity Type | Organization
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Legal Business Name | THE NAVA CENTER, INC.
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Dates
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Enumeration Date | 11/01/2020
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 1334 S 18TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-4647
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Country | US
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Telephone | 610-585-4844
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Fax |
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Provider Business Mailing Address
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Address Line | 1334 S 18TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-4647
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Country | US
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Telephone | 267-603-3673
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. JESSICA NICOLE SHORE
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Credential | PSYD
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Telephone | 267-603-3673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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