Doctor Name: | MS. MARY A PLONKA |
NPI Number: | 1386070621 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 067724 |
Business Practice Address: | 50 Iroquois Dr Salamanca, NY - 147791361 |
Business Phone Number: | 7169452404 |
Business Fax Number: | 7169455983 |
Mailing Address: | 50 Iroquois Dr, Salamanca High School SALAMANCA |
State: | NY |
Postal Code: | 147791361 |
Phone Number: | 7169452404 |
Fax Number: | 7169455983 |
NPI Enumeration Date: | 09/18/2013 |
NPI Last Update Date: | 09/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 067724 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |