Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SW136464 | PA |
NPI | 1003446527 |
---|---|
Provider Name | Isra Abuyounis |
First Address | Bethlehem, PA 18018-6311 |
Second Address | Bethlehem, PA 18018-6311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2020 |
Last Update Date | 23/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SW136464 | PROFESSIONAL SOCIAL WORK LICENSE (01) | PA |