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General NPI Number Information
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NPI Number | 1851938229
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Entity Type | Individual
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Provider Name | EBONI AISHA GADSON LSW
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Gender | Female
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 525 ROUTE 73 N STE 104
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City | MARLTON
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State | NJ
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Zip | 08053-3422
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Country | US
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Telephone | 609-752-6117
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Fax | 844-990-4131
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Provider Business Mailing Address
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Address Line | 634 W JEFFERSON ST APT 4
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City | PHILADELPHIA
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State | PA
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Zip | 19122-3692
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Country | US
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Telephone | 609-213-7839
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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 | 44SL06441800
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License Number State | NJ
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