Doctor Name: | MS. MARILYN JEAN PANTANO |
NPI Number: | 1043596968 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 042393-1 |
Business Practice Address: | 9265 Main St Clarence, NY - 140311912 |
Business Phone Number: | 7164079175 |
Business Fax Number: | 7164079182 |
Mailing Address: | 48 Gray Birch Ct, EAST AMHERST |
State: | NY |
Postal Code: | 140512144 |
Phone Number: | 7164079175 |
Fax Number: | 7164079182 |
NPI Enumeration Date: | 10/24/2011 |
NPI Last Update Date: | 10/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 042393-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |