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General NPI Number Information
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NPI Number | 1912377250
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Entity Type | Organization
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Legal Business Name | CHRISTINE MASCIARELLI-WALKER
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Dates
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Enumeration Date | 09/29/2015
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Last Update Date | 09/29/2015
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Provider Practice Location Address
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Address Line | 7912 BROUS AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3513
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Country | US
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Telephone | 267-252-7101
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Fax |
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Provider Business Mailing Address
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Address Line | 7912 BROUS AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-3513
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Country | US
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Telephone | 267-252-7101
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. CHRISTINE MASCIARELLI-WALKER
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Credential | LCSW
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Telephone | 267-252-7101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | CW017875
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License Number State | PA
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