Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SW136878 | PA |
NPI | 1003446295 |
---|---|
Provider Name | Brandi Gromley |
First Address | Mc Murray, PA 15317-2685 |
Second Address | Washington, PA 15301-4119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2020 |
Last Update Date | 16/01/2020 |