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NPI Code Detail

MEDICARE: MISS KIMBERLY ANN SAPOLIS LSW

MEDICARE: MISS KIMBERLY ANN SAPOLIS 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
1104100000XSocial WorkerSW124593PA

General Provider Information

NPI Number : 1609902832
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KIMBERLY ANN SAPOLIS LSW
Provider Business Mailing Address
First Line : 181 BROWN ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-4560
Country : US
Telephone Number : 570-709-3314
Fax Number : 570-383-0063
Provider Business Practice Location Address
First Line : 650 BOULEVARD AVE
Second Line :
City : DICKSON CITY
State : PA
Zip : 18519-1710
Country : US
Telephone Number : 570-383-2799
Fax Number : 570-383-0063
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 07/08/2007

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Directions to “ MISS KIMBERLY ANN SAPOLIS LSW” Practice Location

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