Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SC01740 | NJ |
N | 1041S0200X | School Social Worker | NY |
NPI | 1003087297 |
---|---|
Provider Name | Ms. Patricia Anne Casamo |
First Address | Warren, NJ 07059-5650 |
Second Address | Warren, NJ 07059-5650 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2008 |
Last Update Date | 17/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CA649467 | (02) | CA |