Provider Information for 1548617632
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RENEE CAVALLARO MSS, LCSW, CCDP-D
Sex: Female
NPI: 1548617632
Last Updated: 2016-05-18
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1548617632 | ||||||||
| Enumeration Date | 2016-05-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1753 KENDARBREN DR SUITE 612 JAMISON, PA 18929-1043 United States Phone: 215-792-7305 | Fax: | ||||||||
| Primary Practice Address | 1753 KENDARBREN DR SUITE 612 JAMISON, PA 18929-1043 United States Phone: 215-792-7305 | Fax: | ||||||||
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