Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SW138704 | PA |
NPI | 1003579434 |
---|---|
Provider Name | Janelle Leigh Mathe |
First Address | Export, PA 15632-8905 |
Second Address | Export, PA 15632-8905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2021 |
Last Update Date | 21/10/2021 |