Doctor Name: | MS. ANTHONETTE NICOLE DEPRIMO |
NPI Number: | 1922208206 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW |
License Number: | CW016259 |
Business Practice Address: | 154 Main St Blossburg, PA - 169121144 |
Business Phone Number: | 5706382367 |
Business Fax Number: | |
Mailing Address: | 154 Main St, BLOSSBURG |
State: | PA |
Postal Code: | 169121144 |
Phone Number: | 5706382367 |
Fax Number: | |
NPI Enumeration Date: | 07/24/2007 |
NPI Last Update Date: | 01/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CW016259 |
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 |