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Individual
PAUL A GANSTER
Active
Individual
PAUL A GANSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, QCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW013558
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000627389
PENNSYLVANIA BLUE SHIELD
PA
01
—
132643000
MAGELLAN
PA
01
—
166987
VALUE OPTIONS
PA
Enumeration date
02/09/2006
Last updated
09/03/2014
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