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General NPI Number Information
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NPI Number | 1922379197
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Entity Type | Individual
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Provider Name | JACQUELINE LITZ LSW
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Gender | Female
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 800 MACDADE BLVD
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City | COLLINGDALE
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State | PA
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Zip | 19023-3826
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Country | US
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Telephone | 610-938-9373
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Fax |
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Provider Business Mailing Address
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Address Line | 162 KERR PL
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City | LANSDOWNE
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State | PA
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Zip | 19050-1512
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Country | US
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Telephone | 610-574-8574
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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 | SW127465
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License Number State | PA
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