=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851783484
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RITA CLINE MSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2015
-----------------------------------------------------
Last Update Date | 02/18/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2351 FREEDOM WAY SUITE 200
-----------------------------------------------------
City | YORK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17402-9282
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-600-0900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4621 E BERLIN RD
-----------------------------------------------------
City | THOMASVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17364-9569
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-676-3456
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | BH000619
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------