MEDICARE: MR. PEDRO PALOMINO M.S.W.,L.C.S.W

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	1041C0700X	Clinical Social Worker	2004000349	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932103371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PEDRO PALOMINO M.S.W.,L.C.S.W

Provider Business Mailing Address
First Line	:	18242 COUNTY ROAD 409
Second Line	:
City	:	BLOOMFIELD
State	:	MO
Zip	:	63825-8398
Country	:	US
Telephone Number	:	573-568-3391
Fax Number	:

Provider Business Practice Location Address
First Line	:	18242 COUNTY ROAD 409
Second Line	:
City	:	BLOOMFIELD
State	:	MO
Zip	:	63825-8398
Country	:	US
Telephone Number	:	573-568-3391
Fax Number	:

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	05/22/2008

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Directions to “ MR. PEDRO PALOMINO M.S.W.,L.C.S.W” Practice Location

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