MEDICARE: PATTI DEAL L.C.S.W.

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	1041C0700X	Clinical Social Worker	C004495	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134138217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATTI DEAL L.C.S.W.

Provider Business Mailing Address
First Line	:	1305 S CANNON BLVD
Second Line	:
City	:	KANNAPOLIS
State	:	NC
Zip	:	28083-6232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1807 E INNES ST
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28146-6030
Country	:	US
Telephone Number	:	704-633-3616
Fax Number	:

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

Provider Enumeration Date	:	08/06/2006
Last Update Date	:	10/30/2007

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Directions to “ PATTI DEAL L.C.S.W.” Practice Location

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