MEDICARE: JOANNA SMUTZLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1124357405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA SMUTZLER

Provider Business Mailing Address
First Line	:	4510 FRANKFORD AVE
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-3602
Country	:	US
Telephone Number	:	215-831-9882
Fax Number	:	215-831-9887

Provider Business Practice Location Address
First Line	:	432 N 6TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-4004
Country	:	US
Telephone Number	:	215-925-2400
Fax Number	:	215-925-9162

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2009
Last Update Date	:	12/15/2009

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Directions to “ JOANNA SMUTZLER ” Practice Location

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