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General NPI Number Information
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NPI Number | 1154934529
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Entity Type | Organization
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Legal Business Name | THE URBAN HEALING GROUP, LLC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 6901 OLD YORK RD APT A115
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City | PHILADELPHIA
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State | PA
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Zip | 19126-2238
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Country | US
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Telephone | 267-467-4806
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Fax | 215-501-5600
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Provider Business Mailing Address
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Address Line | 6901 OLD YORK RD APT A115
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City | PHILADELPHIA
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State | PA
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Zip | 19126-2238
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Country | US
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Telephone | 267-467-4806
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY THERAP
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Name | MS. ARIKA LYNNETTE MOODY
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Credential | LMFT
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Telephone | 267-467-4806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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