Individual
JESSE ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
930 CENTRE ST, ASHLAND, PA 17921-1244
(570) 205-2066
Mailing address
930 CENTRE ST, ASHLAND, PA 17921-1244
(610) 205-2066
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW126588
PA
Other
Enumeration date
09/23/2011
Last updated
07/21/2015
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