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General NPI Number Information
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NPI Number | 1427589779
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Entity Type | Individual
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Provider Name | DONALD ANKLAM LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 1017 MUMMA RD STE 202
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City | WORMLEYSBURG
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State | PA
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Zip | 17043-1145
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Country | US
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Telephone | 717-219-9903
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Fax |
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Provider Business Mailing Address
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Address Line | 1017 MUMMA RD STE 202
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City | WORMLEYSBURG
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State | PA
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Zip | 17043-1145
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Country | US
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Telephone | 717-219-9903
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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 | SW131427
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License Number State | PA
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