Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | CW016003 | PA |
NPI | 1003079427 |
---|---|
Provider Name | Shushma Patel |
First Address | Lansdale, PA 19446-3067 |
Second Address | Lansdale, PA 19446-3067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 07/07/2008 |