Healthcare Provider Details

I. General information

NPI: 1912722463
Provider Name (Legal Business Name): KARLA AGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S WASHINGTON AVE
SCRANTON PA
18505-1639
US

IV. Provider business mailing address

820 S WASHINGTON AVE
SCRANTON PA
18505-1639
US

V. Phone/Fax

Practice location:
  • Phone: 570-595-4496
  • Fax: 570-955-0139
Mailing address:
  • Phone: 570-595-4496
  • Fax: 570-955-0139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW141336
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: