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Individual
MR. JOHN ANDREW IMPAVIDO SR.
Active
Individual
MR. JOHN ANDREW IMPAVIDO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED LPC CAC
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
PC001735
PA
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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