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NPI Code Detail

MEDICARE: MS. SARAH ANNE BOHANNON LSW

MEDICARE:  MS. SARAH ANNE BOHANNON  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 WorkerSW128215PA

General Provider Information

NPI Number : 1720426810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARAH ANNE BOHANNON LSW
Provider Business Mailing Address
First Line : 444 N 3RD ST
Second Line : 5TH FLOOR
City : PHILADELPHIA
State : PA
Zip : 19123-4107
Country : US
Telephone Number : 609-440-4233
Fax Number :
Provider Business Practice Location Address
First Line : 444 N 3RD ST
Second Line : 5TH FLOOR
City : PHILADELPHIA
State : PA
Zip : 19123-4107
Country : US
Telephone Number : 609-440-4233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2013
Last Update Date : 06/11/2013

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Directions to “ MS. SARAH ANNE BOHANNON LSW” Practice Location

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