Doctor Name: | MISS ANGIE M. SHAHMORADI |
NPI Number: | 1164567905 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | CW017024 |
Business Practice Address: | 334 York St Gettysburg, PA - 173251930 |
Business Phone Number: | 7173370026 |
Business Fax Number: | 7173371260 |
Mailing Address: | 200 N 7th St, LEBANON |
State: | PA |
Postal Code: | 170465040 |
Phone Number: | 7172731710 |
Fax Number: | 7173371260 |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 09/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CW017024 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |