Doctor Name: | MR. VICTOR JOHN MANOCCHIO |
NPI Number: | 1487828554 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | |
Business Practice Address: | 6 Sunnyside Rd Tunkhannock, PA - 186576950 |
Business Phone Number: | 5708367777 |
Business Fax Number: | 5708367479 |
Mailing Address: | 6 Sunnyside Rd, TUNKHANNOCK |
State: | PA |
Postal Code: | 186576950 |
Phone Number: | 5708367777 |
Fax Number: | 5708367479 |
NPI Enumeration Date: | 04/18/2008 |
NPI Last Update Date: | 04/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |