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General NPI Number Information
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NPI Number | 1710203898
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Entity Type | Individual
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Provider Name | AUTUMN ROSE PERLSTEIN CSW
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Gender | Female
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 1440 RUSSELL RD
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City | PAOLI
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State | PA
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Zip | 19301-1236
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Country | US
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Telephone | 610-644-6464
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Fax | 610-644-4066
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Provider Business Mailing Address
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Address Line | 8400 BUSTLETON AVE SUITE 200
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City | PHILADELPHIA
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State | PA
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Zip | 19152-1918
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Country | US
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Telephone | 610-644-6464
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Fax | 215-342-9377
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW016365
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License Number State | PA
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