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General NPI Number Information
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NPI Number | 1609431600
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Entity Type | Organization
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Legal Business Name | JOSEPH L. NINES, LLC
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 05/06/2019
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Provider Practice Location Address
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Address Line | 12 E MILL RD
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City | FLOURTOWN
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State | PA
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Zip | 19031-2027
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Country | US
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Telephone | 215-836-4276
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Fax | 215-233-1081
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Provider Business Mailing Address
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Address Line | 12 E MILL RD
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City | FLOURTOWN
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State | PA
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Zip | 19031-2027
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Country | US
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Telephone | 215-836-4276
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Fax | 215-233-1081
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH LOUIS NINES
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Credential | PHD, LMFT
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Telephone | 215-836-4276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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