Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SW1858257 | PA |
NPI | 1003438698 |
---|---|
Provider Name | Shannon Berkey |
First Address | Johnstown, PA 15904-3318 |
Second Address | Johnstown, PA 15904-3318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2020 |
Last Update Date | 18/05/2020 |