Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SW131731 | PA |
NPI | 1003311598 |
---|---|
Provider Name | Nicole Marie Adams |
First Address | Lancaster, PA 17601-6308 |
Second Address | Lancaster, PA 17601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2018 |
Last Update Date | 27/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103308066001 | (05) | PA |