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General NPI Number Information
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NPI Number | 1346762267
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Entity Type | Individual
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Provider Name | YANCUN WISSEH MS
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Gender | Male
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 236 SPRING VALLEY ROAD
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City | DARBY
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State | PA
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Zip | 19023
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Country | US
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Telephone | 215-868-8293
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Fax |
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Provider Business Mailing Address
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Address Line | 236 SPRING VALLEY RD
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City | DARBY
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State | PA
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Zip | 19023-1420
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Country | US
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Telephone | 215-868-8293
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC008194
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-22835
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License Number State | AZ
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