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NPI Code Detail

MEDICARE: HEAL AND RESET THERAPY PLLC

MEDICARE: HEAL AND RESET THERAPY PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist

General Provider Information

NPI Number : 1710836739
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEAL AND RESET THERAPY PLLC
Provider Business Mailing Address
First Line : 113 N 50TH ST APT 2
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-2786
Country : US
Telephone Number : 267-603-3202
Fax Number :
Provider Business Practice Location Address
First Line : 113 N 50TH ST APT 2
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-2786
Country : US
Telephone Number : 267-603-3202
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AJABEYANG AMIN
Credential : PSYD
Telephone Number : 267-603-3202
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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Directions to “HEAL AND RESET THERAPY PLLC ” Practice Location

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