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General NPI Number Information
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NPI Number | 1760497051
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Entity Type | Individual
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Provider Name | PATRICIA B SHANFELD LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 130 SOUTH BRYN MAWR AVE BRYN MAWR HOSPITAL IN PATIENT PSYCHIATRY
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City | BRYN MAWR
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State | PA
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Zip | 19010
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Country | US
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Telephone | 610-526-4283
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Fax | 610-526-4587
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Provider Business Mailing Address
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Address Line | 49 WOODCROFT RD
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City | HAVERTOWN
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State | PA
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Zip | 19083
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Country | US
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Telephone |
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | CW012837
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License Number State | PA
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