MEDICARE: MS. VALERIE DANIEL LMSW

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	SW125609	PA

General Provider Information

NPI Number	:	1932404837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VALERIE DANIEL LMSW

Provider Business Mailing Address
First Line	:	PO BOX 1624
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-6224
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 CARPENTER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2110
Country	:	US
Telephone Number	:	267-679-8198
Fax Number	:

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

Provider Enumeration Date	:	01/24/2011
Last Update Date	:	01/24/2011

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