Provider Demographics
NPI:1487300505
Name:HUFF, THERON (MA)
Entity type:Individual
Prefix:
First Name:THERON
Middle Name:
Last Name:HUFF
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2006
Mailing Address - Country:US
Mailing Address - Phone:484-356-6520
Mailing Address - Fax:
Practice Address - Street 1:123 S BROAD ST STE 1641
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19109-1027
Practice Address - Country:US
Practice Address - Phone:267-457-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor