Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003567744 |
---|---|
Provider Name | Theresa Michele Jeffries |
First Address | Brownsville, PA 15417-9601 |
Second Address | Rostraver Township, PA 15012-4020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2022 |
Last Update Date | 14/01/2022 |