MEDICARE: AMELIA CARROLL WOJENSKI 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
1	104100000X	Social Worker	SW139250	PA

General Provider Information

NPI Number	:	1710734348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELIA CARROLL WOJENSKI LSW

Provider Business Mailing Address
First Line	:	929 SPRUCE ST APT A
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5894
Country	:	US
Telephone Number	:	856-857-5342
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 S 4TH ST STE 598
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-1581
Country	:	US
Telephone Number	:	267-585-2980
Fax Number	:

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

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	05/06/2024

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