MEDICARE: KAYLISHA ESTEVEZ

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	SW141317	PA

General Provider Information

NPI Number	:	1225888118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLISHA ESTEVEZ

Provider Business Mailing Address
First Line	:	8 N QUEEN ST FL 9
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 N QUEEN ST FL 3
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-3816
Country	:	US
Telephone Number	:	717-297-0515
Fax Number	:

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

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	03/25/2024

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Directions to “ KAYLISHA ESTEVEZ ” Practice Location

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