MEDICARE: MS. KATHERINE VICTORIA JRATEH MSS, LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW126188	PA

General Provider Information

NPI Number	:	1134391568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE VICTORIA JRATEH MSS, LSW

Provider Business Mailing Address
First Line	:	7545 MALVERN AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19151-2815
Country	:	US
Telephone Number	:	215-877-4469
Fax Number	:

Provider Business Practice Location Address
First Line	:	7545 MALVERN AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19151-2815
Country	:	US
Telephone Number	:	215-877-4469
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	03/26/2008

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