MEDICARE: STEPHANIE MARIE GARRIEL MSW

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	44SL05311000	NJ

General Provider Information

NPI Number	:	1962780734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MARIE GARRIEL MSW

Provider Business Mailing Address
First Line	:	26 HONEYSUCKLE DR
Second Line	:
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-4114
Country	:	US
Telephone Number	:	856-603-0513
Fax Number	:

Provider Business Practice Location Address
First Line	:	1417 W OREGON AVE
Second Line	:	CATCH 2ND FL
City	:	PHILA
State	:	PA
Zip	:	19145-4926
Country	:	US
Telephone Number	:	215-334-1311
Fax Number	:

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

Provider Enumeration Date	:	07/28/2011
Last Update Date	:	07/28/2011

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