| Tai | |
|
1213 Vine St Suite 117 Philadelphia PA 19107-1111 | |
| (215) 535-3271 | |
| Not Available |
| Full Name | Tai |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1213 Vine St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Anne Mbette (FOUNDER) |
| Authorized Official Contact | 2155353271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tai 1213 Vine St Suite 117 Philadelphia PA 19107-1111 Ph: (215) 535-3271 | Tai 1213 Vine St Suite 117 Philadelphia PA 19107-1111 Ph: (215) 535-3271 |
| NPI Number | 1073840476 |
|---|---|
| Provider Enumeration Date | 11/06/2009 |
| Last Update Date | 11/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073840476 | NPI | - | NPPES |
| 25254340 | Other | PA | DRIVER LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PC004425 (Pennsylvania) | Primary |
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