Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker |
NPI | 1003248501 |
---|---|
Provider Name | Melanie Gonsecki |
First Address | Chester, PA 19013-2040 |
Second Address | Chester, PA 19013-2040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2013 |
Last Update Date | 05/11/2013 |