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NPI Code Detail

MEDICARE: JOANNE M SANTOS LGSW

MEDICARE:   JOANNE M SANTOS  LGSW
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
1104100000XSocial Worker1239GAL

General Provider Information

NPI Number : 1164631040
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNE M SANTOS LGSW
Provider Business Mailing Address
First Line : 106 YVONNE DR
Second Line :
City : ENTERPRISE
State : AL
Zip : 36330-3574
Country : US
Telephone Number : 334-393-9928
Fax Number :
Provider Business Practice Location Address
First Line : 19815 BAY BRANCH RD
Second Line :
City : ANDALUSIA
State : AL
Zip : 36420-9234
Country : US
Telephone Number : 334-222-2525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/08/2007

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Directions to “ JOANNE M SANTOS LGSW” Practice Location

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