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NPI Code Detail

MEDICARE: MONA PATRICIA JAFARIAN

MEDICARE: MONA PATRICIA JAFARIAN
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 Worker07991MD
21041C0700XClinical Social Worker14944SC

General Provider Information

NPI Number : 1841343589
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONA PATRICIA JAFARIAN
Provider Business Mailing Address
First Line : 2674 HIGH BRASS TRL
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-8413
Country : US
Telephone Number : 410-920-7464
Fax Number :
Provider Business Practice Location Address
First Line : 608 16TH AVE N STE G
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-3537
Country : US
Telephone Number : 843-823-5132
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 03/15/2022

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Directions to “ MONA PATRICIA JAFARIAN ” Practice Location

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