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General NPI Number Information
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NPI Number | 1730734575
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Entity Type | Individual
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Provider Name | MRS. MARY ROSE WITTMAN
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Gender | Female
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 100 HINDS ST
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City | TONAWANDA
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State | NY
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Zip | 14150-1815
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Country | US
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Telephone | 716-694-7690
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Fax |
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Provider Business Mailing Address
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Address Line | 4922 OREGON RD
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City | HAMBURG
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State | NY
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Zip | 14075-2619
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Country | US
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Telephone | 716-225-4263
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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