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General NPI Number Information
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NPI Number | 1598337719
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIVING & WELLNESS PARTNERS
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 6060 RIDGE AVE STE 200
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1658
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Country | US
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Telephone | 267-602-1297
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Fax |
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Provider Business Mailing Address
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Address Line | 6024 RIDGE AVE STE 116
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1601
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Country | US
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Telephone | 484-429-9360
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | PAULA L CRAWFORD
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Credential | M.ED, MS, LPC, NCC
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Telephone | 267-602-1297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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