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General NPI Number Information
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NPI Number | 1649836198
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Entity Type | Organization
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Legal Business Name | MOMENTUM COUNSELING & COACHING LLC
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 225 S CHURCH ST
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City | WEST CHESTER
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State | PA
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Zip | 19382-3386
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Country | US
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Telephone | 817-584-0814
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Fax |
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Provider Business Mailing Address
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Address Line | 45 BRIDGE AVE
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City | BERWYN
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State | PA
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Zip | 19312-1760
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Country | US
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Telephone | 817-584-0813
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAURA DINUNZIO
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Credential | LPC
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Telephone | 817-584-0813
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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 |
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License Number State |
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