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NPI Code Detail

MEDICARE: DEBORAH HARRIS-WHITE

MEDICARE:   DEBORAH  HARRIS-WHITE
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 Worker
2104100000XSocial WorkerSW127990PA

General Provider Information

NPI Number : 1639532864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH HARRIS-WHITE
Provider Business Mailing Address
First Line : 7602 BROCKTON RD
Second Line :
City : PHILA
State : PA
Zip : 19151-2826
Country : US
Telephone Number : 215-880-0870
Fax Number :
Provider Business Practice Location Address
First Line : 7602 BROCKTON RD
Second Line :
City : PHILA
State : PA
Zip : 19151-2826
Country : US
Telephone Number : 215-880-0870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2016
Last Update Date : 04/04/2016

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Directions to “ DEBORAH HARRIS-WHITE ” Practice Location

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