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General NPI Number Information
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NPI Number | 1134359136
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Entity Type | Individual
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Provider Name | JOEL DANIEL KIGHTLINGER MSW
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Gender | Male
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Dates
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Enumeration Date | 07/24/2009
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Last Update Date | 07/24/2009
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Provider Practice Location Address
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Address Line | 13180 LESLIE RD STE 2
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City | MEADVILLE
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State | PA
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Zip | 16335-8478
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Country | US
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Telephone | 814-337-6180
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Fax |
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Provider Business Mailing Address
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Address Line | 622 1/2 CUTLER ST
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City | MEADVILLE
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State | PA
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Zip | 16335-1912
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Country | US
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Telephone | 814-853-9096
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW124758
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License Number State | PA
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