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NPI Code Detail

MEDICARE: JO ANN VEDOVA LCSW

MEDICARE:   JO ANN  VEDOVA  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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130341OTHERTXLCSW LICENSE
20004KXOTHERTXBCBS PROVIDER #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548240583
Entity Type Code : Individual
Provider Name (Legal Business Name) : JO ANN VEDOVA LCSW
Provider Business Mailing Address
First Line : PSC 475 BOX 1
Second Line :
City : FPO
State : AP
Zip : 96350-1200
Country : US
Telephone Number : 315-243-3260
Fax Number :
Provider Business Practice Location Address
First Line : PSC 475 BOX 1
Second Line :
City : FPO
State : AP
Zip : 96350-1200
Country : US
Telephone Number : 315-243-3260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 08/02/2024

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Directions to “ JO ANN VEDOVA LCSW” Practice Location

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