Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker |
NPI | 1003334962 |
---|---|
Provider Name | Brenda Goodheart Zenoka |
First Address | Philadelphia, PA 19107-2835 |
Second Address | Philadelphia, PA 19107-2835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2017 |
Last Update Date | 31/08/2017 |