Individual provider · Type 1 NPI
Jack Cottom, LPC
Professional Counselor · Philadelphia, PA
NPI number
1457755696
Active
Practice location
2000 Spring Garden St, 1F
Philadelphia, PA 19130-3994
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | PC009399 (PA) |
Professional Counselor: Definition to come...
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About NPI 1457755696
Jack Cottom, LPC's National Provider Identifier is 1457755696, issued on Oct 17, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Philadelphia, PA. The record was last updated on Jan 19, 2017.