Healthcare Provider Details

I. General information

NPI: 1215257860
Provider Name (Legal Business Name): LAURIE J PLOTSKO BS,LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2010
Last Update Date: 06/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 N 4TH ST
EASTON PA
18042-3518
US

IV. Provider business mailing address

446 E 8TH ST
NORTHAMPTON PA
18067-1804
US

V. Phone/Fax

Practice location:
  • Phone: 610-442-1240
  • Fax:
Mailing address:
  • Phone: 610-442-1240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW127793
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: