| Gmc Lcsw Llc | |
|
241 Main St B Blakely PA 18447-1233 | |
| (570) 947-3163 | |
| Not Available |
| Full Name | Gmc Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 241 Main St, Blakely, Pennsylvania |
| Authorized Official Name and Position | Gina M. Constantini (THERAPIST) |
| Authorized Official Contact | 5709473163 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gmc Lcsw Llc 241 Main St B Blakely PA 18447-1233 Ph: (570) 947-3163 | Gmc Lcsw Llc 241 Main St B Blakely PA 18447-1233 Ph: (570) 947-3163 |
| NPI Number | 1164774279 |
|---|---|
| Provider Enumeration Date | 10/12/2012 |
| Last Update Date | 11/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164774279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CW015803 (* (Not Available)) | Primary |
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