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General NPI Number Information
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NPI Number | 1053411223
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Entity Type | Individual
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Provider Name | KATHLEEN M OSTERTAG L.S.W.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8001 ROOSEVELT BLVD 205-207
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3038
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Country | US
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Telephone | 215-332-1914
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Fax | 215-332-1873
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Provider Business Mailing Address
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Address Line | 3808 SHARP ST
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City | PHILADELPHIA
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State | PA
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Zip | 19127-1816
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Country | US
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Telephone | 215-332-1914
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Fax | 215-332-1873
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW008549L
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License Number State | PA
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