Healthcare Provider Details

I. General information

NPI: 1043250731
Provider Name (Legal Business Name): JO-ANNE HERSH SOCIAL WORKER
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER VICENZA HEALTH CLINIC, UNIT 31403, BOX 13
APO AE
09630
IT

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER ATTN: MCEUL-DCCS (CREDENTIALS), CMR 402
APO AE
09180
DE

V. Phone/Fax

Practice location:
  • Phone: 0390444717604
  • Fax: 0390444716123
Mailing address:
  • Phone: 011496371868839
  • Fax: 011496371866133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50077696
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: