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NPI Code Detail

MEDICARE: MICHELLE RUPPERT-DALY LCSW

MEDICARE: MICHELLE RUPPERT-DALY LCSW
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1376173393
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE RUPPERT-DALY LCSW
Provider Business Mailing Address
First Line : 7301 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-1726
Country : US
Telephone Number : 267-297-5182
Fax Number :
Provider Business Practice Location Address
First Line : 7301 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-1726
Country : US
Telephone Number : 267-297-5182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2020
Last Update Date : 03/03/2023

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