Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | CW017229 | PA |
NPI | 1003169806 |
---|---|
Provider Name | Ms. Clare Deering Deloskey |
First Address | Philadelphia, PA 19147 |
Second Address | Philadelphia, PA 19147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2012 |
Last Update Date | 18/10/2012 |